Provider Demographics
NPI:1922420827
Name:IDEAL HEARING SOLUTIONS LLC
Entity Type:Organization
Organization Name:IDEAL HEARING SOLUTIONS LLC
Other - Org Name:MIRACLE-EAR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/HEARING INSTRUMENT SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:R
Authorized Official - Last Name:WARD
Authorized Official - Suffix:
Authorized Official - Credentials:BC-HIS
Authorized Official - Phone:435-673-8743
Mailing Address - Street 1:616 S RIVER RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-2104
Mailing Address - Country:US
Mailing Address - Phone:435-673-8743
Mailing Address - Fax:435-634-9000
Practice Address - Street 1:616 S RIVER RD
Practice Address - Street 2:SUITE 210
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-2104
Practice Address - Country:US
Practice Address - Phone:435-673-8743
Practice Address - Fax:435-634-9000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-10
Last Update Date:2014-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT2915034601237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT1497031595OtherINDIVIDUAL NPI