Provider Demographics
NPI:1679864227
Name:HEARWELL AUDIOLOGY INC.
Entity Type:Organization
Organization Name:HEARWELL AUDIOLOGY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:C
Authorized Official - Last Name:MILES
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:408-356-1999
Mailing Address - Street 1:14911 NATIONAL AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-2632
Mailing Address - Country:US
Mailing Address - Phone:408-356-1999
Mailing Address - Fax:408-356-1988
Practice Address - Street 1:14911 NATIONAL AVE
Practice Address - Street 2:#2
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032
Practice Address - Country:US
Practice Address - Phone:408-356-1999
Practice Address - Fax:408-356-1988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-29
Last Update Date:2013-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA231H00000X, 332B00000X
CAAU727231H00000X
CAAU883231H00000X
CAAU484231H00000X
CAAU455231H00000X
CAAU2720231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty