=====================================================
General NPI Number Information
=====================================================
NPI Number | 1982003414
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | THE EAR TRUMPET HEARING CENTER INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/20/2014
-----------------------------------------------------
Last Update Date | 08/20/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 605 BRIARWOOD DR SUITE E
-----------------------------------------------------
City | MYRTLE BEACH
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29572-5745
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 843-273-0466
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 605 BRIARWOOD DR SUITE E
-----------------------------------------------------
City | MYRTLE BEACH
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29572-5745
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 843-273-0466
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | KURT W SLAUGHENHOUPT
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 843-273-0466
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332S00000X
-----------------------------------------------------
Taxonomy Name | Hearing Aid Equipment
-----------------------------------------------------
License Number | HAS-0525
-----------------------------------------------------
License Number State | SC
-----------------------------------------------------