Provider Demographics
NPI:1265823835
Name:ROGERS HEARING HEALTHCARE
Entity Type:Organization
Organization Name:ROGERS HEARING HEALTHCARE
Other - Org Name:AUDIBEL HEARING HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AUDIOLOGIST/ OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:J
Authorized Official - Last Name:ROGERS
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-A
Authorized Official - Phone:601-261-5995
Mailing Address - Street 1:PO BOX 17167
Mailing Address - Street 2:
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39404-7167
Mailing Address - Country:US
Mailing Address - Phone:601-261-5995
Mailing Address - Fax:601-261-5335
Practice Address - Street 1:2693 BIENVILLE BLVD
Practice Address - Street 2:UNIT 5
Practice Address - City:OCEAN SPRINGS
Practice Address - State:MS
Practice Address - Zip Code:39564-3106
Practice Address - Country:US
Practice Address - Phone:228-872-6006
Practice Address - Fax:228-872-6004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSA3163332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS04979391Medicaid