Provider Demographics
NPI:1609160324
Name:SOUNDWISE HEARING AID TECHNOLOGIES
Entity Type:Organization
Organization Name:SOUNDWISE HEARING AID TECHNOLOGIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CLARENCE
Authorized Official - Middle Name:C
Authorized Official - Last Name:COOK
Authorized Official - Suffix:
Authorized Official - Credentials:ACA, HIS
Authorized Official - Phone:412-754-0320
Mailing Address - Street 1:728 LONG RUN ROAD
Mailing Address - Street 2:
Mailing Address - City:MCKEESPORT
Mailing Address - State:PA
Mailing Address - Zip Code:15132
Mailing Address - Country:US
Mailing Address - Phone:412-754-0320
Mailing Address - Fax:412-754-0855
Practice Address - Street 1:728 LONG RUN RD
Practice Address - Street 2:
Practice Address - City:MCKEESPORT
Practice Address - State:PA
Practice Address - Zip Code:15132-7427
Practice Address - Country:US
Practice Address - Phone:412-754-0320
Practice Address - Fax:412-754-0855
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-31
Last Update Date:2011-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAF02823332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA220355OtherHIGHMARK BLUE CROSS/BLUE SHIELD