Provider Demographics
NPI:1245611656
Name:CENTRAL MISSOURI AUDIOLOGY & HEARING AID CENTER, INC.
Entity Type:Organization
Organization Name:CENTRAL MISSOURI AUDIOLOGY & HEARING AID CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAIME
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMPSHIRE
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:660-998-3623
Mailing Address - Street 1:1145 S MORLEY ST
Mailing Address - Street 2:
Mailing Address - City:MOBERLY
Mailing Address - State:MO
Mailing Address - Zip Code:65270-1901
Mailing Address - Country:US
Mailing Address - Phone:660-998-3623
Mailing Address - Fax:
Practice Address - Street 1:1145 S MORLEY ST
Practice Address - Street 2:
Practice Address - City:MOBERLY
Practice Address - State:MO
Practice Address - Zip Code:65270-1901
Practice Address - Country:US
Practice Address - Phone:660-998-3623
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-11
Last Update Date:2015-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007027352231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty