Provider Demographics
NPI:1659907947
Name:WATERSHED HEARING INC.
Entity Type:Organization
Organization Name:WATERSHED HEARING INC.
Other - Org Name:LOWRY HEARING AID CENTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DISPENSER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BILL
Authorized Official - Middle Name:BRODY
Authorized Official - Last Name:RINK
Authorized Official - Suffix:
Authorized Official - Credentials:AAS-HIS
Authorized Official - Phone:417-553-0724
Mailing Address - Street 1:2640 E 32ND ST STE 11
Mailing Address - Street 2:
Mailing Address - City:JOPLIN
Mailing Address - State:MO
Mailing Address - Zip Code:64804-4311
Mailing Address - Country:US
Mailing Address - Phone:417-553-0724
Mailing Address - Fax:417-553-3478
Practice Address - Street 1:2640 E 32ND ST STE 11
Practice Address - Street 2:
Practice Address - City:JOPLIN
Practice Address - State:MO
Practice Address - Zip Code:64804-4311
Practice Address - Country:US
Practice Address - Phone:417-553-0724
Practice Address - Fax:417-553-3478
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-18
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment