Basic Information
| Provider Information | |||||||||
| NPI: | 1104025147 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | BEST HEARING PRODUCTS | ||||||||
| LastName: | |||||||||
| FirstName: | |||||||||
| MiddleName: | |||||||||
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| OtherOrganizationName: | MIRACLE-EAR | ||||||||
| OtherOrganizationType: | 3 | ||||||||
| OtherLastName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 2101 2ND AVE. SE | ||||||||
| Address2: | |||||||||
| City: | CAMBRIDGE | ||||||||
| State: | MN | ||||||||
| PostalCode: | 55008 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7636893226 | ||||||||
| FaxNumber: | 7636893024 | ||||||||
| Practice Location | |||||||||
| Address1: | 2101 2ND AVE SE | ||||||||
| Address2: | |||||||||
| City: | CAMBRIDGE | ||||||||
| State: | MN | ||||||||
| PostalCode: | 550084137 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7636893226 | ||||||||
| FaxNumber: | 7636893024 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/11/2007 | ||||||||
| LastUpdateDate: | 02/03/2011 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | VOTAVA | ||||||||
| AuthorizedOfficialFirstName: | TIMOTHY | ||||||||
| AuthorizedOfficialMiddleName: | V | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 7634211688 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 237600000X | Y | 193200000X MULTI-SPECIALTY GROUP | Speech, Language and Hearing Service Providers | Audiologist-Hearing Aid Fitter |
No ID Information.