=====================================================
General NPI Number Information
=====================================================
NPI Number | 1003985938
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HEARING IMPROVEMENT CENTER LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/07/2006
-----------------------------------------------------
Last Update Date | 02/01/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 28 NORTH MAIN STREET
-----------------------------------------------------
City | WEST HARTFORD
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06107-1971
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 860-561-2345
-----------------------------------------------------
Fax | 860-561-2666
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 28 NORTH MAIN STREET
-----------------------------------------------------
City | WEST HARTFORD
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06107-1971
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 860-561-2345
-----------------------------------------------------
Fax | 860-561-2666
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MEMBER LLC
-----------------------------------------------------
Name | MR. ALAN JOHN DUMAINE
-----------------------------------------------------
Credential | MA CCCA
-----------------------------------------------------
Telephone | 860-529-3443
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 237600000X
-----------------------------------------------------
Taxonomy Name | Audiologist-Hearing Aid Fitter
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 231H00000X
-----------------------------------------------------
Taxonomy Name | Audiologist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------