Provider Demographics
NPI:1942510136
Name:ULTIMATE HEARING OLUTIONS DBA
Entity Type:Organization
Organization Name:ULTIMATE HEARING OLUTIONS DBA
Other - Org Name:MIRACLE EAR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SVP OF OPERATIONS
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHIRLEY
Authorized Official - Middle Name:M
Authorized Official - Last Name:DOMINICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-825-1797
Mailing Address - Street 1:815 FAYETTE STREET
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CONSHOHOCKEN
Mailing Address - State:PA
Mailing Address - Zip Code:19428
Mailing Address - Country:US
Mailing Address - Phone:610-825-1797
Mailing Address - Fax:610-825-1801
Practice Address - Street 1:815 FAYETTE STREET
Practice Address - Street 2:SUITE 200
Practice Address - City:CONSHOHOCKEN
Practice Address - State:PA
Practice Address - Zip Code:19428
Practice Address - Country:US
Practice Address - Phone:610-825-1797
Practice Address - Fax:610-825-1801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-21
Last Update Date:2010-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPA F2971332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment