Provider Demographics
NPI:1568897023
Name:FREEDOM HEARING CENTER LLC
Entity Type:Organization
Organization Name:FREEDOM HEARING CENTER LLC
Other - Org Name:FREEDOM HEARING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JUDD
Authorized Official - Middle Name:
Authorized Official - Last Name:PALMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-266-9668
Mailing Address - Street 1:925 SW 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:CANBY
Mailing Address - State:OR
Mailing Address - Zip Code:97013-3832
Mailing Address - Country:US
Mailing Address - Phone:503-266-9668
Mailing Address - Fax:503-266-9662
Practice Address - Street 1:925 SW 4TH AVE
Practice Address - Street 2:
Practice Address - City:CANBY
Practice Address - State:OR
Practice Address - Zip Code:97013-3832
Practice Address - Country:US
Practice Address - Phone:503-266-9668
Practice Address - Fax:503-266-9662
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-03
Last Update Date:2013-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR10133480332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment