Provider Demographics
NPI:1255875985
Name:SPARTA HEARING AID CENTER
Entity type:Organization
Organization Name:SPARTA HEARING AID CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TEDDY
Authorized Official - Middle Name:K
Authorized Official - Last Name:DAY
Authorized Official - Suffix:
Authorized Official - Credentials:HEARING AID SPEC
Authorized Official - Phone:931-739-4327
Mailing Address - Street 1:4379 MONTEREY HWY
Mailing Address - Street 2:
Mailing Address - City:SPARTA
Mailing Address - State:TN
Mailing Address - Zip Code:38583-2749
Mailing Address - Country:US
Mailing Address - Phone:931-739-4327
Mailing Address - Fax:931-739-4326
Practice Address - Street 1:4379 MONTEREY HWY
Practice Address - Street 2:
Practice Address - City:SPARTA
Practice Address - State:TN
Practice Address - Zip Code:38583-2749
Practice Address - Country:US
Practice Address - Phone:931-739-4327
Practice Address - Fax:931-739-4326
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-14
Last Update Date:2020-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332S00000X
TN403332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment