MEDICARE: ENHANCED HEARING AID CENTER 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
1	332S00000X	Hearing Aid Equipment

General Provider Information

NPI Number	:	1679769525
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ENHANCED HEARING AID CENTER LLC

Provider Business Mailing Address
First Line	:	3006 E SUNSHINE ST
Second Line	:
City	:	SPRINGFIELD
State	:	MO
Zip	:	65804-2032
Country	:	US
Telephone Number	:	417-883-2400
Fax Number	:	417-877-8859

Provider Business Practice Location Address
First Line	:	3006 E SUNSHINE ST
Second Line	:
City	:	SPRINGFIELD
State	:	MO
Zip	:	65804-2032
Country	:	US
Telephone Number	:	417-883-2400
Fax Number	:	417-877-8859

Authorized Official
Title or Position	:	OWNER
Name	:	MR. REX MCGEE
Credential	:	BC-HIS
Telephone Number	:	417-883-2400

Provider Enumeration Date	:	09/24/2007
Last Update Date	:	09/24/2007

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