Provider Demographics
NPI:1467749416
Name:HEAR FOR LIFE
Entity Type:Organization
Organization Name:HEAR FOR LIFE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DISPENSER
Authorized Official - Prefix:
Authorized Official - First Name:DANE
Authorized Official - Middle Name:JUSTIN
Authorized Official - Last Name:CARD
Authorized Official - Suffix:
Authorized Official - Credentials:BC HIS
Authorized Official - Phone:435-787-8895
Mailing Address - Street 1:1515 N 400 E
Mailing Address - Street 2:SUITE 105
Mailing Address - City:LOGAN
Mailing Address - State:UT
Mailing Address - Zip Code:84341-7561
Mailing Address - Country:US
Mailing Address - Phone:435-787-8895
Mailing Address - Fax:435-787-8654
Practice Address - Street 1:1515 N 400 E
Practice Address - Street 2:SUITE 105
Practice Address - City:LOGAN
Practice Address - State:UT
Practice Address - Zip Code:84341-7561
Practice Address - Country:US
Practice Address - Phone:435-787-8895
Practice Address - Fax:435-787-8654
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-28
Last Update Date:2011-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6314898-4601332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment