Provider Demographics
NPI:1407005978
Name:NEW BEDFORD HEARING AID SERVICE LLC
Entity Type:Organization
Organization Name:NEW BEDFORD HEARING AID SERVICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LIMITED LIABILITY COMPANY
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:KRAUSE
Authorized Official - Suffix:
Authorized Official - Credentials:HIS
Authorized Official - Phone:508-763-3544
Mailing Address - Street 1:48 LANTERN LN
Mailing Address - Street 2:
Mailing Address - City:ACUSHNET
Mailing Address - State:MA
Mailing Address - Zip Code:02743-1004
Mailing Address - Country:US
Mailing Address - Phone:508-763-3544
Mailing Address - Fax:
Practice Address - Street 1:48 LANTERN LN
Practice Address - Street 2:
Practice Address - City:ACUSHNET
Practice Address - State:MA
Practice Address - Zip Code:02743-1004
Practice Address - Country:US
Practice Address - Phone:508-763-3544
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-09
Last Update Date:2008-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA255841237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA000962658Medicaid