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General NPI Number Information
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NPI Number | 1851681258
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Entity Type | Organization
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Legal Business Name | GW & PE INCORP.
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Dates
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Enumeration Date | 04/19/2011
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Last Update Date | 04/19/2011
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Provider Practice Location Address
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Address Line | 849 E 23RD ST
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City | FREMONT
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State | NE
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Zip | 68025-2444
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Country | US
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Telephone | 140-272-1921
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Fax |
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Provider Business Mailing Address
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Address Line | 849 E 23RD ST
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City | FREMONT
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State | NE
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Zip | 68025-2444
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Country | US
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Telephone | 140-272-1921
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Fax |
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Authorized Official
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Title or Position | HEARING AID DISPENSER
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Name | GARY PAYNE
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Credential | HEARING AID DISPENSE
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Telephone | 14027219213
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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 | 580
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License Number State | NE
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