Provider Demographics
NPI:1740619659
Name:THE HEARING AID STORE
Entity Type:Organization
Organization Name:THE HEARING AID STORE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:
Authorized Official - Last Name:COMFORT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-282-0055
Mailing Address - Street 1:8911 PATTERSON AVE STE B
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23229-6370
Mailing Address - Country:US
Mailing Address - Phone:804-282-0055
Mailing Address - Fax:804-282-4762
Practice Address - Street 1:8911 PATTERSON AVE STE B
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23229-6370
Practice Address - Country:US
Practice Address - Phone:804-282-0055
Practice Address - Fax:804-282-4762
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-01
Last Update Date:2013-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2101001892237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty