=====================================================
General NPI Number Information
=====================================================
NPI Number | 1740632397
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HEARING REHABILITATION SOLUTIONS, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/07/2016
-----------------------------------------------------
Last Update Date | 07/07/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1260 FULTON AVE SUITE B
-----------------------------------------------------
City | SACRAMENTO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95825-7314
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 888-844-0477
-----------------------------------------------------
Fax | 888-844-6994
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1260 FULTON AVE SUITE B
-----------------------------------------------------
City | SACRAMENTO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95825-7314
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 888-844-0477
-----------------------------------------------------
Fax | 888-844-6994
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MR. MICHAEL W. KEMP
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 888-844-0477
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332S00000X
-----------------------------------------------------
Taxonomy Name | Hearing Aid Equipment
-----------------------------------------------------
License Number | AU 1640
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------