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General NPI Number Information
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NPI Number | 1104124825
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Entity Type | Organization
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Legal Business Name | PREMIER HEARING II
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Dates
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Enumeration Date | 03/03/2011
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Last Update Date | 03/03/2011
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Provider Practice Location Address
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Address Line | 1111B LEXINGTON AVE
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City | MANSFIELD
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State | OH
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Zip | 44907-2251
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Country | US
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Telephone | 419-526-4327
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Fax |
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Provider Business Mailing Address
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Address Line | 1111B LEXINGTON AVE
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City | MANSFIELD
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State | OH
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Zip | 44907-2251
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Country | US
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Telephone | 419-526-4327
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | MS. SUSAN KAY SCHAD
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Credential |
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Telephone | 419-526-4327
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332S00000X
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Taxonomy Name | Hearing Aid Equipment
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License Number | 01996263
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License Number State | OH
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