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
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
332S00000X  Y SuppliersHearing Aid Equipment 

No ID Information.


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