Provider Demographics
NPI:1114465770
Name:KENTUCKIANA HEARING SERVICE LLC
Entity Type:Organization
Organization Name:KENTUCKIANA HEARING SERVICE LLC
Other - Org Name:SOMERSET/KENTUCKIANA HEARING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:D
Authorized Official - Last Name:KIMBLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-561-6727
Mailing Address - Street 1:6141 S HIGHWAY 27
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42501-6092
Mailing Address - Country:US
Mailing Address - Phone:606-561-6727
Mailing Address - Fax:
Practice Address - Street 1:6141 S HIGHWAY 27
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42501-6092
Practice Address - Country:US
Practice Address - Phone:606-561-6727
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-03
Last Update Date:2017-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment