Provider Demographics
NPI:1578767307
Name:CHICKASHA HEARING AID CENTER
Entity Type:Organization
Organization Name:CHICKASHA HEARING AID CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:MSCSD
Authorized Official - Phone:405-222-4444
Mailing Address - Street 1:2201 W IOWA AVE
Mailing Address - Street 2:SUITE 5
Mailing Address - City:CHICKASHA
Mailing Address - State:OK
Mailing Address - Zip Code:73018-2739
Mailing Address - Country:US
Mailing Address - Phone:405-222-4444
Mailing Address - Fax:405-222-4402
Practice Address - Street 1:2201 W IOWA AVE
Practice Address - Street 2:SUITE 5
Practice Address - City:CHICKASHA
Practice Address - State:OK
Practice Address - Zip Code:73018-2739
Practice Address - Country:US
Practice Address - Phone:405-222-4444
Practice Address - Fax:405-222-4402
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DBM MARKETING, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-06-14
Last Update Date:2009-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1004237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty