Provider Demographics
NPI:1598001349
Name:HEARING STATION CORP
Entity Type:Organization
Organization Name:HEARING STATION CORP
Other - Org Name:HEARING AID STATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:HEARING AID DISPENSER
Authorized Official - Prefix:
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:NATHAN
Authorized Official - Suffix:
Authorized Official - Credentials:HIS
Authorized Official - Phone:818-900-4327
Mailing Address - Street 1:1415 E COLORADO ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91205-1533
Mailing Address - Country:US
Mailing Address - Phone:818-900-4327
Mailing Address - Fax:818-561-3510
Practice Address - Street 1:1415 E COLORADO ST
Practice Address - Street 2:SUITE 201
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91205-1533
Practice Address - Country:US
Practice Address - Phone:818-900-4327
Practice Address - Fax:818-561-3510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-26
Last Update Date:2012-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA237600000XOtherTAXONOMY CODE
CAHA7647OtherHEARING AID DISPENSING LICENSE