Basic Information
Provider Information
NPI: 1770251704
EntityType: 2
ReplacementNPI:  
OrganizationName: MY HEARING CENTERS, LLC
LastName:  
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Mailing Information
Address1: 8941 S 700 E
Address2:  
City: SANDY
State: UT
PostalCode: 84070
CountryCode: US
TelephoneNumber: 7326886486
FaxNumber:  
Practice Location
Address1: 325 HANSON ST
Address2:  
City: WINNEMUCCA
State: NV
PostalCode: 894453607
CountryCode: US
TelephoneNumber: 8882300875
FaxNumber: 8013967066
Other Information
ProviderEnumerationDate: 09/03/2021
LastUpdateDate: 09/03/2021
NPIDeactivationReasonCode:  
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AuthorizedOfficialLastName: HAMPP
AuthorizedOfficialFirstName: EILEEN
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: VP
AuthorizedOfficialTelephone: 7326886486
IsSoleProprietor:  
IsOrganizationSubpart: Y
ParentOrganizationLBN: MY HEARING CENTERS, LLC
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NPICertificationDate: 08/19/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
237600000X  Y193200000X MULTI-SPECIALTY GROUPSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter 

ID Information
IDTypeStateIssuerDescription
NV2021210446701NVNEVADA STATE BUSINESS IDOTHER


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