Provider Demographics
NPI:1922318310
Name:JAMIE S BONATCH LLC
Entity Type:Organization
Organization Name:JAMIE S BONATCH LLC
Other - Org Name:PROFESSIONAL HEARING AID SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:S
Authorized Official - Last Name:BONATCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-548-4801
Mailing Address - Street 1:141 S JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:KITTANNING
Mailing Address - State:PA
Mailing Address - Zip Code:16201-2409
Mailing Address - Country:US
Mailing Address - Phone:724-548-4801
Mailing Address - Fax:724-548-4801
Practice Address - Street 1:141 S JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:KITTANNING
Practice Address - State:PA
Practice Address - Zip Code:16201-2409
Practice Address - Country:US
Practice Address - Phone:724-548-4801
Practice Address - Fax:724-548-4801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-19
Last Update Date:2010-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAFO3029237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty