Provider Demographics
NPI:1235372657
Name:HEARING HEALTH CENTERS, PC
Entity Type:Organization
Organization Name:HEARING HEALTH CENTERS, PC
Other - Org Name:CHEROKEE HEARING AID SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RALPH
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:712-262-7774
Mailing Address - Street 1:119 E 5TH ST
Mailing Address - Street 2:PO BOX 17
Mailing Address - City:SPENCER
Mailing Address - State:IA
Mailing Address - Zip Code:51301-5012
Mailing Address - Country:US
Mailing Address - Phone:712-262-7774
Mailing Address - Fax:
Practice Address - Street 1:791 N 2ND ST
Practice Address - Street 2:
Practice Address - City:CHEROKEE
Practice Address - State:IA
Practice Address - Zip Code:51012-1289
Practice Address - Country:US
Practice Address - Phone:712-225-2585
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-15
Last Update Date:2009-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA512237600000X
IA788237600000X
IA075237600000X
IA177237600000X
IA706237600000X
IA949237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0125815Medicaid