Provider Demographics
NPI:1649308776
Name:REIERSON'S HERAING AID, INC
Entity type:Organization
Organization Name:REIERSON'S HERAING AID, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:DUANE
Authorized Official - Last Name:REIERSON
Authorized Official - Suffix:
Authorized Official - Credentials:BC IHS
Authorized Official - Phone:605-334-5771
Mailing Address - Street 1:2101 W 41ST ST
Mailing Address - Street 2:WESTERN MALL SUITE 06
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105-6195
Mailing Address - Country:US
Mailing Address - Phone:605-334-5771
Mailing Address - Fax:605-334-8478
Practice Address - Street 1:2101 W 41ST ST
Practice Address - Street 2:WESTERN MALL SUITE 06
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-6195
Practice Address - Country:US
Practice Address - Phone:605-334-5771
Practice Address - Fax:605-334-8478
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2008-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD125332S00000X, 237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Multi-Specialty
No332S00000XSuppliersHearing Aid EquipmentGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD9151370Medicaid