Provider Demographics
NPI:1083845697
Name:MIRACLE-EAR, INC.
Entity Type:Organization
Organization Name:MIRACLE-EAR, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR VICE PRESIDENT HUMAN RESOURC
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-268-4115
Mailing Address - Street 1:5000 CHESHIRE PKWY N
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55446-4103
Mailing Address - Country:US
Mailing Address - Phone:763-268-4115
Mailing Address - Fax:763-268-4017
Practice Address - Street 1:3917 BROADWAY
Practice Address - Street 2:
Practice Address - City:MT. VERNON
Practice Address - State:IL
Practice Address - Zip Code:62864
Practice Address - Country:US
Practice Address - Phone:618-242-1120
Practice Address - Fax:618-242-4171
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AMPLIFON USA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-07-30
Last Update Date:2014-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Multi-Specialty