Provider Demographics
NPI:1417439068
Name:MARIS COMPANY, LLC
Entity Type:Organization
Organization Name:MARIS COMPANY, LLC
Other - Org Name:MARIS HEARING CENTER, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:HEARING AID FITTER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARILYN
Authorized Official - Middle Name:LUCY
Authorized Official - Last Name:SCHROEDER
Authorized Official - Suffix:
Authorized Official - Credentials:HIS
Authorized Official - Phone:507-694-1862
Mailing Address - Street 1:2744 220TH AVE
Mailing Address - Street 2:
Mailing Address - City:IVANHOE
Mailing Address - State:MN
Mailing Address - Zip Code:56142-4110
Mailing Address - Country:US
Mailing Address - Phone:507-694-1862
Mailing Address - Fax:507-694-1405
Practice Address - Street 1:366 E GEORGE ST
Practice Address - Street 2:
Practice Address - City:IVANHOE
Practice Address - State:MN
Practice Address - Zip Code:56142-9711
Practice Address - Country:US
Practice Address - Phone:507-694-1416
Practice Address - Fax:507-694-1405
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MARIS COMPANY, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-08-30
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2668237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty