Provider Demographics
NPI:1578733630
Name:HOZER'S HEARING AID SERVICE, INC.
Entity Type:Organization
Organization Name:HOZER'S HEARING AID SERVICE, INC.
Other - Org Name:HOZER'S HEARING CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:JANET
Authorized Official - Last Name:BRENGMAN
Authorized Official - Suffix:
Authorized Official - Credentials:CCC-A
Authorized Official - Phone:989-791-2100
Mailing Address - Street 1:2042 E HOTCHKISS RD
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48706-9083
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:989-791-2323
Practice Address - Street 1:2135 BRENNER ST
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48602-3628
Practice Address - Country:US
Practice Address - Phone:989-791-2100
Practice Address - Fax:989-791-2323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-05
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1601000030237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3500137Medicaid