MEDICARE: ULTIMATE HEARING SOLUTIONS

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	237700000X	Hearing Instrument Specialist	PA F03256	PA

General Provider Information

NPI Number	:	1184877664
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ULTIMATE HEARING SOLUTIONS

Provider Business Mailing Address
First Line	:	PO BOX 2375
Second Line	:
City	:	SOUTHEASTERN
State	:	PA
Zip	:	19399-2375
Country	:	US
Telephone Number	:	610-337-2806
Fax Number	:	610-337-0674

Provider Business Practice Location Address
First Line	:	160 N GULPH RD
Second Line	:	SEARS HEARING AID CENTER
City	:	KING OF PRUSSIA
State	:	PA
Zip	:	19406-2937
Country	:	US
Telephone Number	:	610-337-2806
Fax Number	:

Authorized Official
Title or Position	:	SVP OF OPERATIONS
Name	:	SHIRLEY M DOMINICK
Credential	:
Telephone Number	:	610-337-2806

Provider Enumeration Date	:	10/29/2008
Last Update Date	:	10/29/2008

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