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General NPI Number Information
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NPI Number | 1770254674
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Entity Type | Organization
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Legal Business Name | PREMIER HEARING AIDS LLC
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Dates
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Enumeration Date | 09/22/2021
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Last Update Date | 09/22/2021
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Provider Practice Location Address
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Address Line | 1006 N YORK ST
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City | MUSKOGEE
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State | OK
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Zip | 74403-3135
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Country | US
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Telephone | 918-694-5270
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Fax | 918-912-2029
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Provider Business Mailing Address
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Address Line | 1006 N YORK ST
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City | MUSKOGEE
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State | OK
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Zip | 74403-3135
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Country | US
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Telephone | 918-694-5270
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Fax | 918-912-2029
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Authorized Official
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Title or Position | OWNER
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Name | MR. RONNIE BUTTRESS
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Credential | BC-HIS
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Telephone | 918-694-5270
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number |
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License Number State |
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