Provider Demographics
NPI:1720296676
Name:ALEXANDRIA HEARING CENTER
Entity Type:Organization
Organization Name:ALEXANDRIA HEARING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DISPENSER
Authorized Official - Prefix:
Authorized Official - First Name:TOM
Authorized Official - Middle Name:
Authorized Official - Last Name:YAGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:320-763-2889
Mailing Address - Street 1:1520 COUNTY ROAD 120 NE
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:MN
Mailing Address - Zip Code:56308-8007
Mailing Address - Country:US
Mailing Address - Phone:320-846-4495
Mailing Address - Fax:
Practice Address - Street 1:3015 HIGHWAY 29 S
Practice Address - Street 2:SUITE 4055
Practice Address - City:ALEXANDRIA
Practice Address - State:MN
Practice Address - Zip Code:56308-3486
Practice Address - Country:US
Practice Address - Phone:320-763-2889
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2302237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Multi-Specialty