Provider Demographics
NPI:1619372869
Name:MAYMAR HEARING AID CORPORATION
Entity Type:Organization
Organization Name:MAYMAR HEARING AID CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:
Authorized Official - Last Name:MAYHEW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-963-1234
Mailing Address - Street 1:102 W ROUTE 66
Mailing Address - Street 2:SUITE A
Mailing Address - City:GLENDORA
Mailing Address - State:CA
Mailing Address - Zip Code:91740-6202
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:102 W ROUTE 66
Practice Address - Street 2:SUITE A
Practice Address - City:GLENDORA
Practice Address - State:CA
Practice Address - Zip Code:91740-6202
Practice Address - Country:US
Practice Address - Phone:626-963-1234
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-30
Last Update Date:2014-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty