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General NPI Number Information
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NPI Number | 1568839207
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Entity Type | Organization
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Legal Business Name | MIDWEST HEARING CENTER, LLC
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Dates
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Enumeration Date | 08/28/2015
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Last Update Date | 08/28/2015
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Provider Practice Location Address
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Address Line | 11627 GRAVOIS RD
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City | SAINT LOUIS
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State | MO
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Zip | 63126-3013
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Country | US
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Telephone | 314-729-1326
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Fax |
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Provider Business Mailing Address
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Address Line | 11627 GRAVOIS RD
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City | SAINT LOUIS
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State | MO
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Zip | 63126-3013
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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 | OWNER/AUDIOLOGIST
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Name | PAMELA MOSHER
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Credential | M.S., CCC-A
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Telephone | 314-729-1326
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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 | 108339
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License Number State | MO
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