Provider Demographics
NPI:1073291720
Name:PARADIGM HEARING CENTER, LLC
Entity Type:Organization
Organization Name:PARADIGM HEARING CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:JOHNSTON
Authorized Official - Suffix:
Authorized Official - Credentials:HEARING AID FITTER
Authorized Official - Phone:208-582-2600
Mailing Address - Street 1:PO BOX 345
Mailing Address - Street 2:
Mailing Address - City:ST MARIES
Mailing Address - State:ID
Mailing Address - Zip Code:83861-0345
Mailing Address - Country:US
Mailing Address - Phone:208-582-2600
Mailing Address - Fax:
Practice Address - Street 1:229 S 7TH ST
Practice Address - Street 2:
Practice Address - City:ST MARIES
Practice Address - State:ID
Practice Address - Zip Code:83861-1803
Practice Address - Country:US
Practice Address - Phone:208-582-2600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-11
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty