Provider Demographics
NPI:1942547419
Name:PROFESSIONAL HEARING SOLUTIONS
Entity Type:Organization
Organization Name:PROFESSIONAL HEARING SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:
Authorized Official - Last Name:SWEET
Authorized Official - Suffix:
Authorized Official - Credentials:#709 LICENSED HEARIN
Authorized Official - Phone:515-955-2985
Mailing Address - Street 1:328 S 25TH ST
Mailing Address - Street 2:
Mailing Address - City:FORT DODGE
Mailing Address - State:IA
Mailing Address - Zip Code:50501-4316
Mailing Address - Country:US
Mailing Address - Phone:515-955-2985
Mailing Address - Fax:515-955-6088
Practice Address - Street 1:328 S 25TH ST
Practice Address - Street 2:
Practice Address - City:FORT DODGE
Practice Address - State:IA
Practice Address - Zip Code:50501-4316
Practice Address - Country:US
Practice Address - Phone:515-955-2985
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-03
Last Update Date:2013-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment