Provider Demographics
NPI:1912968983
Name:CEDAR RAPIDS HEARING CENTER
Entity Type:Organization
Organization Name:CEDAR RAPIDS HEARING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:L
Authorized Official - Last Name:SICKELKA
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:319-286-8782
Mailing Address - Street 1:1825 - 29TH ST NE
Mailing Address - Street 2:STE A
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52402-3452
Mailing Address - Country:US
Mailing Address - Phone:319-286-8782
Mailing Address - Fax:319-286-8798
Practice Address - Street 1:1825 - 29TH ST NE
Practice Address - Street 2:STE A
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402-3452
Practice Address - Country:US
Practice Address - Phone:319-286-8782
Practice Address - Fax:319-286-8798
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-30
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA309231H00000X
IA523332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
No332S00000XSuppliersHearing Aid EquipmentGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
7739065OtherAETNA
F228696OtherMIDLANDS CHOICE