Provider Demographics
NPI:1578665550
Name:MID - AMERICA HEARING CENTER, INC
Entity Type:Organization
Organization Name:MID - AMERICA HEARING CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:GEORGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:417-466-7184
Mailing Address - Street 1:1050 W HAYWARD DR
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:MO
Mailing Address - Zip Code:65712-6329
Mailing Address - Country:US
Mailing Address - Phone:417-466-7184
Mailing Address - Fax:417-466-4081
Practice Address - Street 1:1050 W HAYWARD DR
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:MO
Practice Address - Zip Code:65712-6329
Practice Address - Country:US
Practice Address - Phone:417-466-7184
Practice Address - Fax:417-466-4081
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-01
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty