Basic Information
Provider Information | |||||||||
NPI: | 1861662249 | ||||||||
EntityType: | 2 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: | HUH INC | ||||||||
LastName: |   | ||||||||
FirstName: |   | ||||||||
MiddleName: |   | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: |   | ||||||||
OtherOrganizationName: | EARS 2U HEARING AID SERVICES | ||||||||
OtherOrganizationType: | 3 | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 7 EDGEWATER DRIVE | ||||||||
Address2: |   | ||||||||
City: | PAGOSA SPRINGS | ||||||||
State: | CO | ||||||||
PostalCode: | 81147 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 9707314554 | ||||||||
FaxNumber: | 9707311868 | ||||||||
Practice Location | |||||||||
Address1: | 121 JUSTICE CENTER RD STE D | ||||||||
Address2: |   | ||||||||
City: | CANON CITY | ||||||||
State: | CO | ||||||||
PostalCode: | 81212 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 7192761082 | ||||||||
FaxNumber: | 7192769497 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 03/03/2008 | ||||||||
LastUpdateDate: | 12/22/2011 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: |   | ||||||||
AuthorizedOfficialLastName: | ERICKSON | ||||||||
AuthorizedOfficialFirstName: | GENNETTE | ||||||||
AuthorizedOfficialMiddleName: | M | ||||||||
AuthorizedOfficialTitleorPosition: | SECRETARY FOR HUH INC. | ||||||||
AuthorizedOfficialTelephone: | 9707314554 | ||||||||
IsSoleProprietor: |   | ||||||||
IsOrganizationSubpart: | Y | ||||||||
ParentOrganizationLBN: | HUH INC | ||||||||
AuthorizedOfficialNamePrefix: | MRS. | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 237700000X | 212 | CO | N | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Speech, Language and Hearing Service Providers | Hearing Instrument Specialist |   | 237700000X |   |   | N | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Speech, Language and Hearing Service Providers | Hearing Instrument Specialist |   | 237700000X | 174 | CO | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Speech, Language and Hearing Service Providers | Hearing Instrument Specialist |   |
No ID Information.