Provider Demographics
NPI:1982805123
Name:PVP AUDIO, INC.
Entity Type:Organization
Organization Name:PVP AUDIO, INC.
Other - Org Name:PROFESSIONAL HEARING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AUDIOLOGIST, OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:V
Authorized Official - Last Name:PUTZIER
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:785-827-3849
Mailing Address - Street 1:249 S SANTA FE AVE
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-3931
Mailing Address - Country:US
Mailing Address - Phone:785-827-3849
Mailing Address - Fax:
Practice Address - Street 1:1322 E. IRON
Practice Address - Street 2:
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401
Practice Address - Country:US
Practice Address - Phone:785-827-3849
Practice Address - Fax:785-827-3849
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-29
Last Update Date:2016-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS751237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100314090BMedicaid
KS100314090BMedicaid
KS115406Medicare ID - Type UnspecifiedPERFORMING PROVIDER #
KSR76018Medicare UPIN