Provider Demographics
NPI:1659681062
Name:OPTISOUND HEARING INC
Entity Type:Organization
Organization Name:OPTISOUND HEARING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:D
Authorized Official - Last Name:FINLAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-237-5322
Mailing Address - Street 1:2350 VIA CAPORATTI DR STE B
Mailing Address - Street 2:
Mailing Address - City:POCATELLO
Mailing Address - State:ID
Mailing Address - Zip Code:83201-5095
Mailing Address - Country:US
Mailing Address - Phone:208-237-5322
Mailing Address - Fax:
Practice Address - Street 1:2350 VIA CAPORATTI DR STE B
Practice Address - Street 2:
Practice Address - City:POCATELLO
Practice Address - State:ID
Practice Address - Zip Code:83201-5095
Practice Address - Country:US
Practice Address - Phone:208-237-5322
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-19
Last Update Date:2015-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDHA 1040332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID8P017OtherDURABLE MEDICAL EQUIPMENT