Provider Demographics
NPI:1225250434
Name:MEADVILLE HEARING AIDS, INC
Entity Type:Organization
Organization Name:MEADVILLE HEARING AIDS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:WENDELL
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:479-484-5485
Mailing Address - Street 1:5111 ROGERS AVE
Mailing Address - Street 2:CENTRAL MALL SUITE 550
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72903-2047
Mailing Address - Country:US
Mailing Address - Phone:479-484-5485
Mailing Address - Fax:479-484-7051
Practice Address - Street 1:5111 ROGERS AVE
Practice Address - Street 2:CENTRAL MALL SUITE 550
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72903-2047
Practice Address - Country:US
Practice Address - Phone:479-484-5485
Practice Address - Fax:479-484-7051
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2017-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR16237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR49212OtherBCBS