Provider Demographics
NPI:1508640244
Name:EARMAX LLC
Entity Type:Organization
Organization Name:EARMAX LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRESHEA
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:HIS
Authorized Official - Phone:504-799-9575
Mailing Address - Street 1:625 S BURNSIDE AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:GONZALES
Mailing Address - State:LA
Mailing Address - Zip Code:70737-3400
Mailing Address - Country:US
Mailing Address - Phone:225-562-8871
Mailing Address - Fax:
Practice Address - Street 1:625 S BURNSIDE AVE STE 3
Practice Address - Street 2:
Practice Address - City:GONZALES
Practice Address - State:LA
Practice Address - Zip Code:70737-3400
Practice Address - Country:US
Practice Address - Phone:225-562-8871
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-23
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech