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General NPI Number Information
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NPI Number | 1669007381
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Entity Type | Organization
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Legal Business Name | LAKE CHARLES HEARING AIDS LLC
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Dates
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Enumeration Date | 03/04/2020
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Last Update Date | 03/04/2020
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Provider Practice Location Address
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Address Line | 1756 RYAN ST
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City | LAKE CHARLES
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State | LA
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Zip | 70601-6050
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Country | US
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Telephone | 337-433-1522
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Fax |
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Provider Business Mailing Address
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Address Line | 555 DR MICHAEL DEBAKEY DR STE 104
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City | LAKE CHARLES
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State | LA
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Zip | 70601-5700
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Country | US
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Telephone | 337-436-3277
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Fax | 337-439-3051
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Authorized Official
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Title or Position | OWNER
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Name | HEIDI JOY SORRELLS
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Credential | AUD
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Telephone | 337-436-3277
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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 |
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License Number State |
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