Provider Demographics
NPI:1740317809
Name:SUN CITY HEARING SERVICE
Entity type:Organization
Organization Name:SUN CITY HEARING SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:WELDON
Authorized Official - Middle Name:KARL
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:MA CCC-A
Authorized Official - Phone:951-679-8751
Mailing Address - Street 1:28125 BRADLEY RD
Mailing Address - Street 2:SUITE 140
Mailing Address - City:SUN CITY
Mailing Address - State:CA
Mailing Address - Zip Code:92586-2248
Mailing Address - Country:US
Mailing Address - Phone:951-679-8751
Mailing Address - Fax:951-679-8751
Practice Address - Street 1:28125 BRADLEY RD
Practice Address - Street 2:SUITE 140
Practice Address - City:SUN CITY
Practice Address - State:CA
Practice Address - Zip Code:92586-2248
Practice Address - Country:US
Practice Address - Phone:951-679-8751
Practice Address - Fax:951-679-8751
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Not Answered332S00000XSuppliersHearing Aid Equipment