Provider Demographics
NPI:1407527047
Name:HUSKERLAND HEARING CENTER LLC
Entity Type:Organization
Organization Name:HUSKERLAND HEARING CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CAMERON
Authorized Official - Middle Name:
Authorized Official - Last Name:ELLISON
Authorized Official - Suffix:
Authorized Official - Credentials:HIS
Authorized Official - Phone:308-379-4773
Mailing Address - Street 1:819 N DIERS AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68803-4957
Mailing Address - Country:US
Mailing Address - Phone:308-395-8107
Mailing Address - Fax:
Practice Address - Street 1:819 N DIERS AVE STE 1
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68803-4957
Practice Address - Country:US
Practice Address - Phone:308-395-8107
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-23
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty