Provider Demographics
NPI:1225309842
Name:HEARLAB, LLC
Entity Type:Organization
Organization Name:HEARLAB, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TOM
Authorized Official - Middle Name:H
Authorized Official - Last Name:SHOLTEN
Authorized Official - Suffix:
Authorized Official - Credentials:NBC-HIS
Authorized Official - Phone:205-978-5881
Mailing Address - Street 1:1651 INDEPENDENCE CT
Mailing Address - Street 2:STE 151
Mailing Address - City:HOMEWOOD
Mailing Address - State:AL
Mailing Address - Zip Code:35209
Mailing Address - Country:US
Mailing Address - Phone:205-978-5881
Mailing Address - Fax:205-978-5884
Practice Address - Street 1:1651 INDEPENDENCE CT
Practice Address - Street 2:STE 151
Practice Address - City:HOMEWOOD
Practice Address - State:AL
Practice Address - Zip Code:35209
Practice Address - Country:US
Practice Address - Phone:205-978-5881
Practice Address - Fax:205-978-5884
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-13
Last Update Date:2012-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4100237700000X
AL2201237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty