Provider Demographics
NPI:1245852037
Name:HEARING DEPOT LLC
Entity type:Organization
Organization Name:HEARING DEPOT LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/HEARING AID DEALER/SUPPLIER
Authorized Official - Prefix:
Authorized Official - First Name:TREVER
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:FLUKE
Authorized Official - Suffix:
Authorized Official - Credentials:HIS
Authorized Official - Phone:734-477-9907
Mailing Address - Street 1:4025 CARPENTER RD
Mailing Address - Street 2:
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48197-9644
Mailing Address - Country:US
Mailing Address - Phone:734-477-9907
Mailing Address - Fax:734-477-9908
Practice Address - Street 1:4025 CARPENTER RD
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-9644
Practice Address - Country:US
Practice Address - Phone:734-477-9907
Practice Address - Fax:734-477-9908
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-14
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty