Provider Demographics
NPI:1003999079
Name:B & S UNITED AGENCY D/B/A MIRACLE EAR
Entity Type:Organization
Organization Name:B & S UNITED AGENCY D/B/A MIRACLE EAR
Other - Org Name:MIRACLE EAR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FRANCHISEE
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:A
Authorized Official - Last Name:HILL-COOLEY
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BC-HIS
Authorized Official - Phone:573-547-2346
Mailing Address - Street 1:1321 W SAINTE MARIES ST STE A
Mailing Address - Street 2:
Mailing Address - City:PERRYVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63775-1596
Mailing Address - Country:US
Mailing Address - Phone:573-547-2346
Mailing Address - Fax:573-547-6228
Practice Address - Street 1:1321 W SAINTE MARIES ST STE A
Practice Address - Street 2:
Practice Address - City:PERRYVILLE
Practice Address - State:MO
Practice Address - Zip Code:63775-1596
Practice Address - Country:US
Practice Address - Phone:573-547-2346
Practice Address - Fax:573-547-6228
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO000816237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO265769OtherHEALTHLINK
MO4500042OtherUNITED HEALTHCARE
MO107541OtherBLUECROSS BLUESHIELD
MOHEAOtherMERCY HEALTH PLANS