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General NPI Number Information
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NPI Number | 1124463260
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Entity Type | Organization
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Legal Business Name | HEARCARE LLC
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Dates
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Enumeration Date | 05/02/2013
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Last Update Date | 05/02/2013
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Provider Practice Location Address
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Address Line | 2821 8TH ST S
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City | WISCONSIN RAPIDS
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State | WI
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Zip | 54494-6294
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Country | US
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Telephone | 715-423-4327
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Fax | 715-421-3300
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Provider Business Mailing Address
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Address Line | 2821 8TH ST S
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City | WISCONSIN RAPIDS
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State | WI
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Zip | 54494-6294
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Country | US
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Telephone | 715-423-4327
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Fax | 715-421-3300
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | TIMOTHY LIPPOLD
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Credential |
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Telephone | 715-423-4327
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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 | 296156
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License Number State | WI
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