Provider Demographics
NPI:1609060359
Name:PIONEER HEARING AID CENTERS, INC.
Entity Type:Organization
Organization Name:PIONEER HEARING AID CENTERS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KELLI
Authorized Official - Middle Name:
Authorized Official - Last Name:COLBENSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-364-3931
Mailing Address - Street 1:515 W GRAY AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73071
Mailing Address - Country:US
Mailing Address - Phone:405-364-3931
Mailing Address - Fax:405-364-9032
Practice Address - Street 1:515 W GRAY AVE
Practice Address - Street 2:SUITE A
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73071
Practice Address - Country:US
Practice Address - Phone:405-364-3931
Practice Address - Fax:405-364-9032
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-05
Last Update Date:2017-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK346332S00000X
332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment