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NPI Code Detail

MEDICARE: THE HEARING LAB LLC

MEDICARE: THE HEARING LAB LLC
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
1237700000XHearing Instrument Specialist4118-4203IL

General Provider Information

NPI Number : 1417384496
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE HEARING LAB LLC
Provider Business Mailing Address
First Line : 2151 BLUESTONE DR
Second Line :
City : SAINT CHARLES
State : MO
Zip : 63303-6704
Country : US
Telephone Number : 855-703-4637
Fax Number : 636-946-1754
Provider Business Practice Location Address
First Line : 2151 BLUESTONE DR
Second Line :
City : SAINT CHARLES
State : MO
Zip : 63303-6704
Country : US
Telephone Number : 855-703-4637
Fax Number : 636-946-1754
Authorized Official
Title or Position : OWNER
Name : MR. MICHAEL STEVEN MARINO
Credential : B.C.-H.I.S.
Telephone Number : 855-703-4637
Provider Enumeration Date : 10/04/2013
Last Update Date : 10/04/2013

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Directions to “THE HEARING LAB LLC ” Practice Location

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