Provider Demographics
NPI:1518383553
Name:EAGLE HEARING LLC
Entity Type:Organization
Organization Name:EAGLE HEARING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ABRAM
Authorized Official - Middle Name:
Authorized Official - Last Name:VORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-610-8111
Mailing Address - Street 1:440 E STATE ST STE 100
Mailing Address - Street 2:
Mailing Address - City:EAGLE
Mailing Address - State:ID
Mailing Address - Zip Code:83616-5935
Mailing Address - Country:US
Mailing Address - Phone:319-610-8111
Mailing Address - Fax:
Practice Address - Street 1:440 E STATE ST STE 100
Practice Address - Street 2:
Practice Address - City:EAGLE
Practice Address - State:ID
Practice Address - Zip Code:83616-5935
Practice Address - Country:US
Practice Address - Phone:319-610-8111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-14
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDAUD-2414231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty