=====================================================
General NPI Number Information
=====================================================
NPI Number | 1447065727
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SCHROEDER'S HEARING AID SERVICES & AUDIOLOGY INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/12/2025
-----------------------------------------------------
Last Update Date | 02/12/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 522 ADDISON AVE W
-----------------------------------------------------
City | TWIN FALLS
-----------------------------------------------------
State | ID
-----------------------------------------------------
Zip | 83301-5039
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 208-913-0224
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 522 ADDISON AVE W
-----------------------------------------------------
City | TWIN FALLS
-----------------------------------------------------
State | ID
-----------------------------------------------------
Zip | 83301-5039
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 208-913-0224
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | GREG SCHROEDER
-----------------------------------------------------
Credential | HIS
-----------------------------------------------------
Telephone | 208-544-6809
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 237700000X
-----------------------------------------------------
Taxonomy Name | Hearing Instrument Specialist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------