Provider Demographics
NPI:1679981435
Name:HEARING ASSOCIATES OF ALAMOSA INC
Entity Type:Organization
Organization Name:HEARING ASSOCIATES OF ALAMOSA INC
Other - Org Name:MOUNTAIN CARE HEARING CENTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SPEECH, AUDIOLOGY AND HEARING SPEC.
Authorized Official - Prefix:
Authorized Official - First Name:CHESTER
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:SAXON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-326-2791
Mailing Address - Street 1:315 EDISON AVE
Mailing Address - Street 2:
Mailing Address - City:ALAMOSA
Mailing Address - State:CO
Mailing Address - Zip Code:81101-2580
Mailing Address - Country:US
Mailing Address - Phone:719-589-2100
Mailing Address - Fax:719-589-2507
Practice Address - Street 1:315 EDISON AVE
Practice Address - Street 2:
Practice Address - City:ALAMOSA
Practice Address - State:CO
Practice Address - Zip Code:81101-2580
Practice Address - Country:US
Practice Address - Phone:719-589-2100
Practice Address - Fax:719-589-2507
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-24
Last Update Date:2014-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COHAD.0000199332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM26059771Medicaid