Provider Demographics
NPI:1619257318
Name:AFFORDABLE HEARING AID CENTERS
Entity Type:Organization
Organization Name:AFFORDABLE HEARING AID CENTERS
Other - Org Name:AFFORDABLE HEARING AID-CO.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:HEARING INSTRUMENT SPECIALIST
Authorized Official - Prefix:MR
Authorized Official - First Name:JIMMY
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:GOODING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-275-6364
Mailing Address - Street 1:2211 ONEIDA AVE
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45414-5629
Mailing Address - Country:US
Mailing Address - Phone:937-275-6364
Mailing Address - Fax:
Practice Address - Street 1:2211 ONEIDA AVE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45414-5629
Practice Address - Country:US
Practice Address - Phone:937-275-6364
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-25
Last Update Date:2011-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH00551332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0451265Medicaid
OH00551OtherSTATE OF OHIO HEARING AID DEALERS AND FITTERS LICENSING BOARD
OH00551OtherSTATE OF OHIO HEARING AID DEALERS AND FITTERS LICENSING BOARD