Provider Demographics
NPI:1063688414
Name:MEDICAL HEARING SERVICES, INC
Entity Type:Organization
Organization Name:MEDICAL HEARING SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CLIFTON
Authorized Official - Middle Name:O
Authorized Official - Last Name:ISTRE
Authorized Official - Suffix:JR
Authorized Official - Credentials:PHD
Authorized Official - Phone:985-845-3509
Mailing Address - Street 1:350 LAKEVIEW CT
Mailing Address - Street 2:SUITE A
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70433-7514
Mailing Address - Country:US
Mailing Address - Phone:985-845-3509
Mailing Address - Fax:985-867-5498
Practice Address - Street 1:350 LAKEVIEW CT
Practice Address - Street 2:SUITE A
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-7514
Practice Address - Country:US
Practice Address - Phone:985-845-3509
Practice Address - Fax:985-867-5498
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-06
Last Update Date:2013-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA156332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1315583Medicaid