Provider Demographics
NPI:1669862017
Name:REPUBLIC HEARING CARE LLC
Entity Type:Organization
Organization Name:REPUBLIC HEARING CARE LLC
Other - Org Name:REPUBLIC HEARING CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ HIS
Authorized Official - Prefix:
Authorized Official - First Name:MARCEY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:JUMPER
Authorized Official - Suffix:
Authorized Official - Credentials:BCHIS
Authorized Official - Phone:417-732-4327
Mailing Address - Street 1:929 US HIGHWAY 60 E STE B
Mailing Address - Street 2:
Mailing Address - City:REPUBLIC
Mailing Address - State:MO
Mailing Address - Zip Code:65738-1584
Mailing Address - Country:US
Mailing Address - Phone:417-732-4327
Mailing Address - Fax:417-732-4327
Practice Address - Street 1:929 US HIGHWAY 60 E STE B
Practice Address - Street 2:
Practice Address - City:REPUBLIC
Practice Address - State:MO
Practice Address - Zip Code:65738-1584
Practice Address - Country:US
Practice Address - Phone:417-732-4327
Practice Address - Fax:417-732-4327
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-23
Last Update Date:2017-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2017021968237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Multi-Specialty