Provider Demographics
NPI:1952916777
Name:ALLIANCE HEARING AIDS LLC
Entity Type:Organization
Organization Name:ALLIANCE HEARING AIDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:VIETOR
Authorized Official - Suffix:
Authorized Official - Credentials:HAD
Authorized Official - Phone:209-501-5648
Mailing Address - Street 1:802 14TH ST STE N
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95354-1029
Mailing Address - Country:US
Mailing Address - Phone:209-501-5648
Mailing Address - Fax:209-501-8681
Practice Address - Street 1:802 14TH ST STE N
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95354-1029
Practice Address - Country:US
Practice Address - Phone:209-501-5648
Practice Address - Fax:209-501-5648
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-09
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHA3131OtherSTATE DISPENSING LICENSE