Basic Information
Provider Information | |||||||||
NPI: | 1093873705 | ||||||||
EntityType: | 2 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: | SMART HEARING SOLUTIONS LLC | ||||||||
LastName: |   | ||||||||
FirstName: |   | ||||||||
MiddleName: |   | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: |   | ||||||||
OtherOrganizationName: | MIRACLE EAR | ||||||||
OtherOrganizationType: | 3 | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 131 ENTERPRISE RD | ||||||||
Address2: |   | ||||||||
City: | JOHNSTOWN | ||||||||
State: | NY | ||||||||
PostalCode: | 120953326 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 5187362284 | ||||||||
FaxNumber: | 5186205727 | ||||||||
Practice Location | |||||||||
Address1: | 384 N 3RD AVE | ||||||||
Address2: |   | ||||||||
City: | FRUITPORT | ||||||||
State: | MI | ||||||||
PostalCode: | 494159788 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 2318657706 | ||||||||
FaxNumber: | 5187362285 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 12/05/2006 | ||||||||
LastUpdateDate: | 01/12/2022 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: |   | ||||||||
AuthorizedOfficialLastName: | TOTH | ||||||||
AuthorizedOfficialFirstName: | AARON | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: | HEARING INSTRUMENT SPECIALIST | ||||||||
AuthorizedOfficialTelephone: | 8992134338 | ||||||||
IsSoleProprietor: |   | ||||||||
IsOrganizationSubpart: | N | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: | 01/12/2022 |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332S00000X |   |   | Y |   | Suppliers | Hearing Aid Equipment |   |
No ID Information.