Provider Demographics
NPI:1558899419
Name:KENTUCIANA HEARING AIDS, INC
Entity Type:Organization
Organization Name:KENTUCIANA HEARING AIDS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:VIRGINIA LYNN
Authorized Official - Last Name:PHILLIPI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-976-3380
Mailing Address - Street 1:636 SOUTHTOWN BLVD STE 5-400
Mailing Address - Street 2:
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42303-7746
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:636 SOUTHTOWN BLVD STE 5-400
Practice Address - Street 2:
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42303-7746
Practice Address - Country:US
Practice Address - Phone:800-976-3380
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-23
Last Update Date:2017-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY0969480OtherORGANIZATION NUMBER SECRETARY OF STATE