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General NPI Number Information
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NPI Number | 1114355161
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Entity Type | Organization
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Legal Business Name | MB4 ENTERPRISES, INC
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Dates
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Enumeration Date | 10/29/2013
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Last Update Date | 10/29/2013
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Provider Practice Location Address
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Address Line | 1431 N WEBB RD
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City | GRAND ISLAND
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State | NE
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Zip | 68803-2313
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Country | US
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Telephone | 308-381-2747
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Fax |
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Provider Business Mailing Address
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Address Line | 19104 FRANCES CIR
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City | OMAHA
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State | NE
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Zip | 68130-2979
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ROBERT EICH
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Credential |
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Telephone | 402-359-1156
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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 | 772
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 332S00000X
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Taxonomy Name | Hearing Aid Equipment
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License Number | 764
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License Number State | NE
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