Provider Demographics
NPI:1598904039
Name:HELMERT HEARING CLINIC, PA
Entity Type:Organization
Organization Name:HELMERT HEARING CLINIC, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF AUDIOLOGY/ OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STACY
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:HELMERT
Authorized Official - Suffix:
Authorized Official - Credentials:AU D
Authorized Official - Phone:870-424-4838
Mailing Address - Street 1:860 HIGHWAY 62 E
Mailing Address - Street 2:SUITE #8
Mailing Address - City:MOUNTAIN HOME
Mailing Address - State:AR
Mailing Address - Zip Code:72653-3248
Mailing Address - Country:US
Mailing Address - Phone:870-424-4838
Mailing Address - Fax:870-424-4878
Practice Address - Street 1:860 HIGHWAY 62 E
Practice Address - Street 2:SUITE #8
Practice Address - City:MOUNTAIN HOME
Practice Address - State:AR
Practice Address - Zip Code:72653-3248
Practice Address - Country:US
Practice Address - Phone:870-424-4838
Practice Address - Fax:870-424-4878
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-06
Last Update Date:2009-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA#201231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5G158Medicare PIN