Provider Demographics
NPI:1164660536
Name:ASTRUM HEARING SOLUTIONS
Entity Type:Organization
Organization Name:ASTRUM HEARING SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:BLAKE
Authorized Official - Suffix:III
Authorized Official - Credentials:HIS
Authorized Official - Phone:702-240-2059
Mailing Address - Street 1:8440 W LAKE MEAD BLVD STE 112
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-7648
Mailing Address - Country:US
Mailing Address - Phone:702-240-2059
Mailing Address - Fax:702-240-2065
Practice Address - Street 1:8440 W LAKE MEAD BLVD STE 112
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-7648
Practice Address - Country:US
Practice Address - Phone:702-240-2059
Practice Address - Fax:702-240-2065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-23
Last Update Date:2009-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV1504237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty