Provider Demographics
NPI:1417218959
Name:ADVANTAGE HEARING, LLC
Entity Type:Organization
Organization Name:ADVANTAGE HEARING, LLC
Other - Org Name:MIRACLE-EAR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:HAAG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-564-0608
Mailing Address - Street 1:1402 S PARKER RD
Mailing Address - Street 2:A106
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80231-2758
Mailing Address - Country:US
Mailing Address - Phone:303-755-1733
Mailing Address - Fax:303-306-9340
Practice Address - Street 1:1402 S PARKER RD
Practice Address - Street 2:A106
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80231-2758
Practice Address - Country:US
Practice Address - Phone:303-755-1733
Practice Address - Fax:303-306-9340
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-31
Last Update Date:2012-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO200574237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO616411800OtherACS PROVIDER NUMBER