Provider Demographics
NPI:1396325296
Name:CARLSON'S HERITAGE HEARING AID CENTER
Entity type:Organization
Organization Name:CARLSON'S HERITAGE HEARING AID CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:BARTLETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-514-5639
Mailing Address - Street 1:2201 PILLSBURY RD STE 194
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-1373
Mailing Address - Country:US
Mailing Address - Phone:530-514-5639
Mailing Address - Fax:
Practice Address - Street 1:20 HILLTOP DR STE B
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96003-2856
Practice Address - Country:US
Practice Address - Phone:530-223-4567
Practice Address - Fax:530-223-4566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-13
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Multi-Specialty
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1013239037Medicaid