Provider Demographics
NPI:1558751867
Name:RAPID CITY HEARING AID CENTER
Entity Type:Organization
Organization Name:RAPID CITY HEARING AID CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEFFERY
Authorized Official - Middle Name:TED
Authorized Official - Last Name:FRENCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-342-5902
Mailing Address - Street 1:2218 JACKSON BLVD
Mailing Address - Street 2:SUITE 2A
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57702-1501
Mailing Address - Country:US
Mailing Address - Phone:605-342-5902
Mailing Address - Fax:
Practice Address - Street 1:2218 JACKSON BLVD
Practice Address - Street 2:SUITE 2A
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57702-1501
Practice Address - Country:US
Practice Address - Phone:605-342-5902
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-26
Last Update Date:2015-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD216237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD9151400Medicaid