MEDICARE: KING HEARING AID CENTERS INC

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	332S00000X	Hearing Aid Equipment

General Provider Information

NPI Number	:	1508177106
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KING HEARING AID CENTERS INC

Provider Business Mailing Address
First Line	:	8100 E BLOOMINGTON FREEWAY
Second Line	:
City	:	BLOOMINGTON
State	:	MN
Zip	:	55420
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3101 SW 34TH AVE
Second Line	:	STE 803
City	:	OCALA
State	:	FL
Zip	:	34474-7447
Country	:	US
Telephone Number	:	352-861-4327
Fax Number	:

Authorized Official
Title or Position	:	CONTROLLER
Name	:	PETE MARCACCINI
Credential	:
Telephone Number	:	952-769-8165

Provider Enumeration Date	:	06/29/2010
Last Update Date	:	06/29/2010

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