Basic Information
| Provider Information | |||||||||
| NPI: | 1568138519 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MY HEARING CENTERS, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8941 S 700 E | ||||||||
| Address2: | |||||||||
| City: | SANDY | ||||||||
| State: | UT | ||||||||
| PostalCode: | 840702400 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7326886486 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1247 BARING BLVD | ||||||||
| Address2: | |||||||||
| City: | SPARKS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 894348669 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8882300875 | ||||||||
| FaxNumber: | 8013967066 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/19/2021 | ||||||||
| LastUpdateDate: | 08/19/2021 | ||||||||
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| AuthorizedOfficialLastName: | HAMPP | ||||||||
| AuthorizedOfficialFirstName: | EILEEN | ||||||||
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| AuthorizedOfficialTitleorPosition: | VP | ||||||||
| AuthorizedOfficialTelephone: | 7326886486 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 08/19/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 237600000X | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Speech, Language and Hearing Service Providers | Audiologist-Hearing Aid Fitter |
ID Information
| ID | Type | State | Issuer | Description | NV20212104467 | 01 | NV | STATE LICENSE | OTHER |