MEDICARE: HEARMORE HEARING AID CENTER

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	332BC3200X	Customized Equipment (DME)

General Provider Information

NPI Number	:	1952545402
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEARMORE HEARING AID CENTER

Provider Business Mailing Address
First Line	:	1445 WHITE BEAR AVE N
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55106-2404
Country	:	US
Telephone Number	:	651-771-4019
Fax Number	:	651-771-9941

Provider Business Practice Location Address
First Line	:	1445 WHITE BEAR AVE N
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55106-2404
Country	:	US
Telephone Number	:	651-771-4019
Fax Number	:	651-771-9941

Authorized Official
Title or Position	:	MANAGER
Name	:	ALICE ELIZABETH OLSON
Credential	:
Telephone Number	:	651-771-4019

Provider Enumeration Date	:	04/28/2009
Last Update Date	:	04/28/2009

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