Basic Information
| Provider Information | |||||||||
| NPI: | 1417279027 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | AMERICAN HEARING CENTERS, LLC | ||||||||
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| OtherOrganizationName: | SONUS SF0005 | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1675 LEAHY ST | ||||||||
| Address2: | STE 109 | ||||||||
| City: | MUSKEGON | ||||||||
| State: | MI | ||||||||
| PostalCode: | 494425500 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2317285720 | ||||||||
| FaxNumber: | 2317285721 | ||||||||
| Practice Location | |||||||||
| Address1: | 4868 LAKE MICHIGAN DR | ||||||||
| Address2: | STE A | ||||||||
| City: | ALLENDALE | ||||||||
| State: | MI | ||||||||
| PostalCode: | 494019577 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6168508800 | ||||||||
| FaxNumber: | 6168508811 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/23/2010 | ||||||||
| LastUpdateDate: | 05/02/2014 | ||||||||
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| AuthorizedOfficialLastName: | GALLAGHER | ||||||||
| AuthorizedOfficialFirstName: | JEAN | ||||||||
| AuthorizedOfficialMiddleName: | MARIE | ||||||||
| AuthorizedOfficialTitleorPosition: | AUDIOPROSTHOLOGIST | ||||||||
| AuthorizedOfficialTelephone: | 2317285720 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | AMERICAN HEARING CENTERS, LLC | ||||||||
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| AuthorizedOfficialCredential: | BC-HIS, ACA | ||||||||
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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.