Basic Information
| Provider Information | |||||||||
| NPI: | 1972927895 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | AURALCARE HEARING CENTERS OF AMERICA, LLC | ||||||||
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| OtherOrganizationName: | MY HEARING CENTERS | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8941 S 700 E | ||||||||
| Address2: | SUITE 204 | ||||||||
| City: | SANDY | ||||||||
| State: | UT | ||||||||
| PostalCode: | 840702400 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8018498497 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1647 WILLIAMS HWY | ||||||||
| Address2: | |||||||||
| City: | GRANTS PASS | ||||||||
| State: | OR | ||||||||
| PostalCode: | 975275699 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5417737409 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/12/2014 | ||||||||
| LastUpdateDate: | 02/12/2014 | ||||||||
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| AuthorizedOfficialLastName: | LARSEN | ||||||||
| AuthorizedOfficialFirstName: | DAVID | ||||||||
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| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 8018498947 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QH0700X | Y | Ambulatory Health Care Facilities | Clinic/Center | Hearing and Speech |
No ID Information.