| Organization Name: | SAM'S CLUB HEARING AID CENTER |
| NPI Number: | 1053717058 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RICHARD DAVIS (STORE MANAGER) |
| Mailing Address: | 6520 Carlisle Pike Mechanicsburg |
| State: | PA US |
| Postal Code: | 170505251 |
| Phone Number: | 7175163041 |
| Fax Number: | |
| NPI Enumeration Date: | 11/18/2014 |
| NPI Last Update Date: | 01/22/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 237700000X |
| License Number: | F03523 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Hearing Instrument Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | Individuals who test hearing for the selection, adaptation, fitting, adjusting, servicing, and sale of hearing aids. Hearing Instrument Specialist is a designation provided individuals who qualify by the National Hearing Aid Society |