Provider Demographics
NPI:1619420619
Name:BOURRET INC
Entity Type:Organization
Organization Name:BOURRET INC
Other - Org Name:NUEAR HEARING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRENT
Authorized Official - Middle Name:
Authorized Official - Last Name:BOURRET
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-794-1293
Mailing Address - Street 1:3333 BROOKVIEW HILLS BLVD
Mailing Address - Street 2:STE 109
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-5661
Mailing Address - Country:US
Mailing Address - Phone:336-794-1293
Mailing Address - Fax:
Practice Address - Street 1:3333 BROOKVIEW HILLS BLVD
Practice Address - Street 2:STE 109
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-5661
Practice Address - Country:US
Practice Address - Phone:336-794-1293
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-27
Last Update Date:2016-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty