Provider Demographics
NPI:1083029805
Name:QUALITY HEARING AID SERVICE
Entity Type:Organization
Organization Name:QUALITY HEARING AID SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:SIDNEY
Authorized Official - Last Name:GROLNIC
Authorized Official - Suffix:
Authorized Official - Credentials:AUD CCC-A
Authorized Official - Phone:508-875-9773
Mailing Address - Street 1:12 QUILL CIR
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:MA
Mailing Address - Zip Code:02368-2959
Mailing Address - Country:US
Mailing Address - Phone:508-875-9773
Mailing Address - Fax:781-986-8721
Practice Address - Street 1:664 WAVERLY ST
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702-8554
Practice Address - Country:US
Practice Address - Phone:508-875-9773
Practice Address - Fax:781-986-8721
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-01
Last Update Date:2014-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA96332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD110028331FMedicaid