Provider Demographics
NPI:1578191615
Name:MERIDIAN HEARING AIDS LLC
Entity Type:Organization
Organization Name:MERIDIAN HEARING AIDS LLC
Other - Org Name:LESLIE MILLIKEN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLIKEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-572-0005
Mailing Address - Street 1:PO BOX 75
Mailing Address - Street 2:
Mailing Address - City:EAGLE
Mailing Address - State:ID
Mailing Address - Zip Code:83616-0001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:925 N MAIN ST STE D
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83642-2301
Practice Address - Country:US
Practice Address - Phone:208-572-0005
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-01
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty