Provider Demographics
NPI:1013018183
Name:ABERDEEN HEARING CLINIC LLC
Entity Type:Organization
Organization Name:ABERDEEN HEARING CLINIC LLC
Other - Org Name:RICH HEARING AND TINNITUS CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER/ AUDIOLOGIST
Authorized Official - Prefix:MS
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:RICH
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:605-725-4327
Mailing Address - Street 1:2220 6TH AVE SE STE #1
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:SD
Mailing Address - Zip Code:57401-5190
Mailing Address - Country:US
Mailing Address - Phone:605-725-4327
Mailing Address - Fax:605-725-4328
Practice Address - Street 1:2220 6TH AVE SE STE #1
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:SD
Practice Address - Zip Code:57401-5190
Practice Address - Country:US
Practice Address - Phone:605-725-4327
Practice Address - Fax:605-725-4328
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2019-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD327A231H00000X
SDT-316A231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD1013018183OtherNPI MEDICARE
SD1174566830OtherMEDICARE NPI INDIVIDUAL