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NPI Code Detail

MEDICARE: PERSONALIZED HEARING CARE

MEDICARE: PERSONALIZED HEARING CARE
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
1237600000XAudiologist-Hearing Aid Fitter

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10H10426OTHERMIBLUE CROSS BLUE SHIELD
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1447591284
Entity Type Code : Organization
Provider Name (Legal Business Name) : PERSONALIZED HEARING CARE
Provider Business Mailing Address
First Line : 35337 WARREN RD
Second Line :
City : WESTLAND
State : MI
Zip : 48185-2013
Country : US
Telephone Number : 734-467-5100
Fax Number : 734-467-5103
Provider Business Practice Location Address
First Line : 321 PETTIBONE ST
Second Line : SUITE 105
City : SOUTH LYON
State : MI
Zip : 48178-6000
Country : US
Telephone Number : 248-437-5505
Fax Number : 248-437-5518
Authorized Official
Title or Position : OWNER
Name : KARISSA JAGACKI
Credential : AUD
Telephone Number : 734-467-5100
Provider Enumeration Date : 03/04/2013
Last Update Date : 03/04/2013

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Directions to “PERSONALIZED HEARING CARE ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.