Basic Information
| Provider Information | |||||||||
| NPI: | 1033858758 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | MY HEARING CENTERS, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8941 S 700 E | ||||||||
| Address2: | |||||||||
| City: | SANDY | ||||||||
| State: | UT | ||||||||
| PostalCode: | 840702400 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7326886486 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2835 COLLEGE AVE | ||||||||
| Address2: | |||||||||
| City: | CONWAY | ||||||||
| State: | AR | ||||||||
| PostalCode: | 720346144 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8882300875 | ||||||||
| FaxNumber: | 8013967066 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/01/2022 | ||||||||
| LastUpdateDate: | 06/01/2022 | ||||||||
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| AuthorizedOfficialLastName: | HAMPP | ||||||||
| AuthorizedOfficialFirstName: | EILEEN | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | VP | ||||||||
| AuthorizedOfficialTelephone: | 7326886486 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | MY HEARING CENTERS, LLC | ||||||||
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| NPICertificationDate: | 05/18/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332S00000X | Y | Suppliers | Hearing Aid Equipment |
ID Information
| ID | Type | State | Issuer | Description | 2100101 | 01 | AR | WHOLESALE RETAIL LICENSE | OTHER |