Provider Demographics
NPI:1689751018
Name:CENTRAL STATE HEARING AID CENTERS, INC.
Entity Type:Organization
Organization Name:CENTRAL STATE HEARING AID CENTERS, INC.
Other - Org Name:CENTRAL STATE HEARING AID CENTERS
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TIM
Authorized Official - Middle Name:
Authorized Official - Last Name:BRECHEISEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:316-269-4327
Mailing Address - Street 1:303 S HYDRAULIC ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67211-1908
Mailing Address - Country:US
Mailing Address - Phone:316-269-4327
Mailing Address - Fax:316-262-4327
Practice Address - Street 1:303 S HYDRAULIC ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67211-1908
Practice Address - Country:US
Practice Address - Phone:316-269-4327
Practice Address - Fax:316-262-4327
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSCE569332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment