Basic Information
| Provider Information | |||||||||
| NPI: | 1427622596 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | AURALCARE HEARING CENTERS OF AMERICA, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8941 S 700 E | ||||||||
| Address2: | |||||||||
| City: | SANDY | ||||||||
| State: | UT | ||||||||
| PostalCode: | 840702400 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7326886486 | ||||||||
| FaxNumber: | 8013967066 | ||||||||
| Practice Location | |||||||||
| Address1: | 4155 YELLOWSTONE AVE | ||||||||
| Address2: | |||||||||
| City: | CHUBBUCK | ||||||||
| State: | ID | ||||||||
| PostalCode: | 832022385 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2082380020 | ||||||||
| FaxNumber: | 8013967066 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/13/2021 | ||||||||
| LastUpdateDate: | 05/13/2021 | ||||||||
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| AuthorizedOfficialLastName: | HAMPP | ||||||||
| AuthorizedOfficialFirstName: | EILEEN | ||||||||
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| AuthorizedOfficialTitleorPosition: | VP | ||||||||
| AuthorizedOfficialTelephone: | 7326886486 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | AURALCARE HEARING CENTERS OF AMERICA, LLC | ||||||||
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| NPICertificationDate: | 04/07/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 237700000X | N | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Speech, Language and Hearing Service Providers | Hearing Instrument Specialist | 231H00000X | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Speech, Language and Hearing Service Providers | Audiologist |
ID Information
| ID | Type | State | Issuer | Description | 0000439277 | 01 | ID | STATE OF IDAHO ENTITY LICENSE NUMBER | OTHER |