Provider Demographics
NPI:1649562497
Name:ROSALIE FRERICHS
Entity Type:Organization
Organization Name:ROSALIE FRERICHS
Other - Org Name:PRECISION HEARING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROSALIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:FRERICHS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:308-345-1640
Mailing Address - Street 1:PO BOX 31
Mailing Address - Street 2:
Mailing Address - City:MC COOK
Mailing Address - State:NE
Mailing Address - Zip Code:69001-0031
Mailing Address - Country:US
Mailing Address - Phone:308-345-1640
Mailing Address - Fax:308-345-7842
Practice Address - Street 1:1101 W B ST
Practice Address - Street 2:
Practice Address - City:MC COOK
Practice Address - State:NE
Practice Address - Zip Code:69001-3566
Practice Address - Country:US
Practice Address - Phone:308-345-1640
Practice Address - Fax:308-345-7842
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-12
Last Update Date:2011-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NENE443332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025514100Medicaid