Provider Demographics
NPI:1114187374
Name:ADVANCED HEARING CARE
Entity Type:Organization
Organization Name:ADVANCED HEARING CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:BUTCHART
Authorized Official - Suffix:
Authorized Official - Credentials:BC-HIS
Authorized Official - Phone:810-494-4327
Mailing Address - Street 1:8023 GRAND RIVER RD
Mailing Address - Street 2:400
Mailing Address - City:BRIGHTON
Mailing Address - State:MI
Mailing Address - Zip Code:48114-9392
Mailing Address - Country:US
Mailing Address - Phone:810-494-4327
Mailing Address - Fax:810-494-4329
Practice Address - Street 1:8023 GRAND RIVER RD
Practice Address - Street 2:400
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48114-9392
Practice Address - Country:US
Practice Address - Phone:810-494-4327
Practice Address - Fax:810-494-4329
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-11
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI3501001767332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4285400Medicaid