Provider Demographics
NPI:1922464965
Name:PREMIER HEARING HEALTHCARE CENTER, LLC
Entity Type:Organization
Organization Name:PREMIER HEARING HEALTHCARE CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DISPENSER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:ROSENGARTEN
Authorized Official - Suffix:
Authorized Official - Credentials:BC-HIS
Authorized Official - Phone:937-280-4212
Mailing Address - Street 1:8141 N MAIN ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45415-1750
Mailing Address - Country:US
Mailing Address - Phone:937-280-4212
Mailing Address - Fax:937-387-6408
Practice Address - Street 1:8141 N MAIN ST
Practice Address - Street 2:SUITE A
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45415-1750
Practice Address - Country:US
Practice Address - Phone:937-280-4212
Practice Address - Fax:937-387-6408
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-06
Last Update Date:2016-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2651261QH0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech