Provider Demographics
NPI:1043708001
Name:STATCO-PALMER, INC.
Entity Type:Organization
Organization Name:STATCO-PALMER, INC.
Other - Org Name:PALMER HEARING LABORATORY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER OPERATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:CLARE
Authorized Official - Last Name:BEATY
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:501-525-9996
Mailing Address - Street 1:105 CRACKER BOX LANE
Mailing Address - Street 2:SUITE B
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71913
Mailing Address - Country:US
Mailing Address - Phone:501-525-9996
Mailing Address - Fax:501-525-2155
Practice Address - Street 1:105 CRACKER BOX LANE
Practice Address - Street 2:SUITE B
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913
Practice Address - Country:US
Practice Address - Phone:501-525-9996
Practice Address - Fax:501-525-2155
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-25
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR315231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty