Provider Demographics
NPI:1770254674
Name:PREMIER HEARING AIDS LLC
Entity Type:Organization
Organization Name:PREMIER HEARING AIDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RONNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BUTTRESS
Authorized Official - Suffix:
Authorized Official - Credentials:BC-HIS
Authorized Official - Phone:918-694-5270
Mailing Address - Street 1:1006 N YORK ST
Mailing Address - Street 2:
Mailing Address - City:MUSKOGEE
Mailing Address - State:OK
Mailing Address - Zip Code:74403-3135
Mailing Address - Country:US
Mailing Address - Phone:918-694-5270
Mailing Address - Fax:918-912-2029
Practice Address - Street 1:1006 N YORK ST
Practice Address - Street 2:
Practice Address - City:MUSKOGEE
Practice Address - State:OK
Practice Address - Zip Code:74403-3135
Practice Address - Country:US
Practice Address - Phone:918-694-5270
Practice Address - Fax:918-912-2029
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-22
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty
No261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and SpeechGroup - Single Specialty