Provider Demographics
NPI:1457400384
Name:AURALTEC HEARING CENTERS, INC.
Entity Type:Organization
Organization Name:AURALTEC HEARING CENTERS, INC.
Other - Org Name:MIRACLE-EAR HEARING CENTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROLAND
Authorized Official - Middle Name:WESLEY
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:BC-HIS, ACA
Authorized Official - Phone:575-622-2887
Mailing Address - Street 1:109 E 5TH ST
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:NM
Mailing Address - Zip Code:88201-6205
Mailing Address - Country:US
Mailing Address - Phone:575-622-2887
Mailing Address - Fax:575-622-3379
Practice Address - Street 1:109 E 5TH ST
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:NM
Practice Address - Zip Code:88201-6205
Practice Address - Country:US
Practice Address - Phone:575-622-2887
Practice Address - Fax:575-622-3379
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
Last Update Date:2015-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM231H00000X
NM470A237700000X, 332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
No332S00000XSuppliersHearing Aid EquipmentGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMNM00TB54OtherBCBS