Provider Demographics
NPI:1255685616
Name:BARRE OPTICIANS AND HEARING AID CENTER
Entity Type:Organization
Organization Name:BARRE OPTICIANS AND HEARING AID CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEARING INSTRUMENT SPECIALIST
Authorized Official - Prefix:MR
Authorized Official - First Name:SALVATORE
Authorized Official - Middle Name:N
Authorized Official - Last Name:IMPERATO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-355-2191
Mailing Address - Street 1:PO BOX 78
Mailing Address - Street 2:
Mailing Address - City:SOUTH BARRE
Mailing Address - State:MA
Mailing Address - Zip Code:01074-0078
Mailing Address - Country:US
Mailing Address - Phone:978-355-2191
Mailing Address - Fax:978-355-2020
Practice Address - Street 1:395 MAIN STREET SOUTH
Practice Address - Street 2:
Practice Address - City:BARRE PLAINS
Practice Address - State:MA
Practice Address - Zip Code:01005
Practice Address - Country:US
Practice Address - Phone:978-355-2191
Practice Address - Fax:978-355-2020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-06
Last Update Date:2012-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA0034332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA45806OtherFALLON
MA95162501OtherNETWORK HEALTH
MA110028800AMedicaid
MABAROPT123OtherUNICARE