Provider Demographics
NPI:1144420605
Name:HEARING PLUS LLC
Entity Type:Organization
Organization Name:HEARING PLUS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:LARSON
Authorized Official - Last Name:SHIELDS
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:605-996-0281
Mailing Address - Street 1:417 N MAIN ST
Mailing Address - Street 2:SUITE 105
Mailing Address - City:MITCHELL
Mailing Address - State:SD
Mailing Address - Zip Code:57301-2655
Mailing Address - Country:US
Mailing Address - Phone:605-996-0281
Mailing Address - Fax:605-996-6168
Practice Address - Street 1:417 N MAIN ST
Practice Address - Street 2:SUITE 105
Practice Address - City:MITCHELL
Practice Address - State:SD
Practice Address - Zip Code:57301-2655
Practice Address - Country:US
Practice Address - Phone:605-996-0281
Practice Address - Fax:605-996-6168
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-23
Last Update Date:2007-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD21237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD5830472Medicaid
SD5830472Medicaid