Organization Name: | GENE CLARK HEARING AID SERVICE |
NPI Number: | 1447482682 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MERLE EUGENE CLARK (OWNER) |
Mailing Address: | 208 Wabash Mattoon |
State: | IL US |
Postal Code: | 61938 |
Phone Number: | 2172548678 |
Fax Number: | |
NPI Enumeration Date: | 08/21/2009 |
NPI Last Update Date: | 08/21/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332S00000X |
License Number: | 0078 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
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. |