=====================================================
General NPI Number Information
=====================================================
NPI Number | 1124568159
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HEARING SOLUTIONS, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/23/2017
-----------------------------------------------------
Last Update Date | 02/23/2017
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 722 FRONT ST
-----------------------------------------------------
City | LOUISVILLE
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80027-1805
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-666-8149
-----------------------------------------------------
Fax | 303-666-9149
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 722 FRONT ST
-----------------------------------------------------
City | LOUISVILLE
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80027-1805
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-666-8149
-----------------------------------------------------
Fax | 303-666-9149
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | AUDIOLOGIST
-----------------------------------------------------
Name | MRS. CHRISTINE M GERHARDT-JEWELL
-----------------------------------------------------
Credential | MACCC-A
-----------------------------------------------------
Telephone | 303-666-8149
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 237700000X
-----------------------------------------------------
Taxonomy Name | Hearing Instrument Specialist
-----------------------------------------------------
License Number | HAD.0000178
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 231H00000X
-----------------------------------------------------
Taxonomy Name | Audiologist
-----------------------------------------------------
License Number | AUD.0000111
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------