Provider Demographics
NPI:1134450927
Name:NORTHERN NEVADA HEARING AID CENTER LLC
Entity type:Organization
Organization Name:NORTHERN NEVADA HEARING AID CENTER LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:D
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:HIS
Authorized Official - Phone:775-331-2500
Mailing Address - Street 1:658 E PRATER WAY
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89431-4680
Mailing Address - Country:US
Mailing Address - Phone:775-331-2500
Mailing Address - Fax:775-331-2501
Practice Address - Street 1:658 E PRATER WAY
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89431-4680
Practice Address - Country:US
Practice Address - Phone:775-331-2500
Practice Address - Fax:775-331-2501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-19
Last Update Date:2010-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV185237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty