Basic Information
| Provider Information | |||||||||
| NPI: | 1841342425 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | FAMILY HEARING CARE, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 367 | ||||||||
| Address2: | |||||||||
| City: | RIPLEY | ||||||||
| State: | WV | ||||||||
| PostalCode: | 252710367 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3043721122 | ||||||||
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| Practice Location | |||||||||
| Address1: | 229 SOUTH CHURCH STREET | ||||||||
| Address2: | SUITE E | ||||||||
| City: | RIPLEY | ||||||||
| State: | WV | ||||||||
| PostalCode: | 25271 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3043721122 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/17/2007 | ||||||||
| LastUpdateDate: | 09/22/2009 | ||||||||
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| AuthorizedOfficialLastName: | BURDETTE | ||||||||
| AuthorizedOfficialFirstName: | TODD | ||||||||
| AuthorizedOfficialMiddleName: | SHANNON | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 3043721122 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.S., CCC-A | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 237600000X | A-0173 | WV | Y | 193400000X SINGLE SPECIALTY GROUP | Speech, Language and Hearing Service Providers | Audiologist-Hearing Aid Fitter |
No ID Information.