MEDICARE: HEARING REHABILITATION CENTER 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	231H00000X	Audiologist		CO

General Provider Information

NPI Number	:	1649612334
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEARING REHABILITATION CENTER INC

Provider Business Mailing Address
First Line	:	8321 SANGRE DE CRISTO RD
Second Line	:	STE 202
City	:	LITTLETON
State	:	CO
Zip	:	80127-6425
Country	:	US
Telephone Number	:	303-984-4414
Fax Number	:	303-984-6244

Provider Business Practice Location Address
First Line	:	1610 SOUTH 8TH STREET
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80905-0000
Country	:	US
Telephone Number	:	719-634-8801
Fax Number	:	719-634-8895

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	MATTHEW A WILKEN
Credential	:	AUD
Telephone Number	:	303-984-4414

Provider Enumeration Date	:	07/23/2013
Last Update Date	:	08/04/2015

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