| Organization Name: | CLARK'S HEARING AID SERVICE LLC |
| NPI Number: | 1073926994 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | COLE HARMON (OWNER) |
| Mailing Address: | 913 Lake Land Blvd Mattoon |
| State: | IL US |
| Postal Code: | 619385521 |
| Phone Number: | 2172344110 |
| Fax Number: | |
| NPI Enumeration Date: | 06/09/2014 |
| NPI Last Update Date: | 06/09/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332S00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Hearing Aid Equipment |
| Taxonomy Specialization: | |
| Taxonomy Definition: | The manufacture and/or sale of electronic hearing aids, their component parts, and related products and services on a national basis. |