Provider Demographics
NPI:1407223910
Name:MCKINNEY HEARING SOLUTIONS
Entity Type:Organization
Organization Name:MCKINNEY HEARING SOLUTIONS
Other - Org Name:MIRACLE EAR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROVIDER/PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:C
Authorized Official - Last Name:MUNFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-771-3948
Mailing Address - Street 1:479 TURNER MCCALL BLVD NE
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:GA
Mailing Address - Zip Code:30165-2735
Mailing Address - Country:US
Mailing Address - Phone:770-771-3948
Mailing Address - Fax:
Practice Address - Street 1:479 TURNER MCCALL BLVD NE
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:GA
Practice Address - Zip Code:30165-2735
Practice Address - Country:US
Practice Address - Phone:770-771-3948
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-01
Last Update Date:2015-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAHADE035085332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment