Provider Demographics
NPI:1982852539
Name:THE HEARING STORES OF MINNESOTA
Entity Type:Organization
Organization Name:THE HEARING STORES OF MINNESOTA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPLE
Authorized Official - Prefix:MR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:MATTIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-334-8762
Mailing Address - Street 1:12 E 66TH ST
Mailing Address - Street 2:
Mailing Address - City:RICHFIELD
Mailing Address - State:MN
Mailing Address - Zip Code:55423-2454
Mailing Address - Country:US
Mailing Address - Phone:952-223-4438
Mailing Address - Fax:952-223-4438
Practice Address - Street 1:12 E 66TH ST
Practice Address - Street 2:
Practice Address - City:RICHFIELD
Practice Address - State:MN
Practice Address - Zip Code:55423-2454
Practice Address - Country:US
Practice Address - Phone:952-223-4438
Practice Address - Fax:952-223-4438
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MATTIS VENTURES INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-09-08
Last Update Date:2008-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment