Provider Demographics
NPI:1053678979
Name:GENSTLER HEARING CENTER LLC
Entity Type:Organization
Organization Name:GENSTLER HEARING CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DARRELL
Authorized Official - Middle Name:E
Authorized Official - Last Name:GENSTLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:541-928-1667
Mailing Address - Street 1:2700 14TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:OR
Mailing Address - Zip Code:97322-6956
Mailing Address - Country:US
Mailing Address - Phone:541-928-1667
Mailing Address - Fax:541-928-1817
Practice Address - Street 1:2700 14TH AVE SE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:OR
Practice Address - Zip Code:97322-6956
Practice Address - Country:US
Practice Address - Phone:541-928-1667
Practice Address - Fax:541-928-1817
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-16
Last Update Date:2012-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment