Provider Demographics
NPI:1184067043
Name:OMEGA HEARING AIDS LLC
Entity type:Organization
Organization Name:OMEGA HEARING AIDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FITTER/DISPENSER
Authorized Official - Prefix:
Authorized Official - First Name:JESUS
Authorized Official - Middle Name:C
Authorized Official - Last Name:GONZALE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-251-6233
Mailing Address - Street 1:4714 GAVLICK FARM
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78244-1328
Mailing Address - Country:US
Mailing Address - Phone:210-251-6233
Mailing Address - Fax:210-201-8107
Practice Address - Street 1:4714 GAVLICK FARM
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78244-1328
Practice Address - Country:US
Practice Address - Phone:210-251-6233
Practice Address - Fax:210-201-8107
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-10
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment