Provider Demographics
NPI:1295136281
Name:HEARING AID CONSULTANTS
Entity type:Organization
Organization Name:HEARING AID CONSULTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEARING INSTRUMENT SPECIALIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEITRA
Authorized Official - Middle Name:L
Authorized Official - Last Name:SPENCER
Authorized Official - Suffix:
Authorized Official - Credentials:RN,BCHIS
Authorized Official - Phone:573-619-8549
Mailing Address - Street 1:315 ELLIS BLVD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:JEFFERSON CITY
Mailing Address - State:MO
Mailing Address - Zip Code:65101-7802
Mailing Address - Country:US
Mailing Address - Phone:573-636-6061
Mailing Address - Fax:573-636-2675
Practice Address - Street 1:315 ELLIS BLVD
Practice Address - Street 2:SUITE 202
Practice Address - City:JEFFERSON CITY
Practice Address - State:MO
Practice Address - Zip Code:65101-7802
Practice Address - Country:US
Practice Address - Phone:573-636-6061
Practice Address - Fax:573-636-2675
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-09
Last Update Date:2014-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO701332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment