Basic Information
Provider Information
NPI: 1013426063
EntityType: 2
ReplacementNPI:  
OrganizationName: AURALCARE HEARING CENTERS OF AMERICA, LLC
LastName:  
FirstName:  
MiddleName:  
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Credential:  
OtherOrganizationName: MY HEARING CENTERS
OtherOrganizationType: 3
OtherLastName:  
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Mailing Information
Address1: 8941 S 700 E STE 204
Address2:  
City: SANDY
State: UT
PostalCode: 840702402
CountryCode: US
TelephoneNumber: 18018498497
FaxNumber:  
Practice Location
Address1: 220 E HORIZON DR STE D
Address2:  
City: HENDERSON
State: NV
PostalCode: 890158001
CountryCode: US
TelephoneNumber: 7025643592
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/21/2017
LastUpdateDate: 09/21/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: LARSEN
AuthorizedOfficialFirstName: DAVID
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: PRESIDENT
AuthorizedOfficialTelephone: 8018498497
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
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NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
237700000X  Y193400000X SINGLE SPECIALTY GROUPSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist 

No ID Information.


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