MEDICARE: BKT HEARING LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	261QH0700X	Hearing and Speech Clinic/Center
2	332S00000X	Hearing Aid Equipment
3	231H00000X	Audiologist

General Provider Information

NPI Number	:	1104399005
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BKT HEARING LLC

Provider Business Mailing Address
First Line	:	7820 TERREY PINE CT STE 110
Second Line	:
City	:	EDEN PRAIRIE
State	:	MN
Zip	:	55347-1107
Country	:	US
Telephone Number	:	952-594-8358
Fax Number	:	952-479-4639

Provider Business Practice Location Address
First Line	:	7820 TERREY PINE CT STE 110
Second Line	:
City	:	EDEN PRAIRIE
State	:	MN
Zip	:	55347-1107
Country	:	US
Telephone Number	:	952-594-8358
Fax Number	:	952-479-4639

Authorized Official
Title or Position	:	OWNER
Name	:	ELIZABETH THOMAS
Credential	:	AUDIOLOGIST
Telephone Number	:	952-594-8358

Provider Enumeration Date	:	01/03/2019
Last Update Date	:	01/14/2021

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