| Organization Name: | MT. HARRISON AUDIOLOGY AND HEARING AIDS LLC |
| NPI Number: | 1467871913 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CHRISTINE WILCOX PICKUP (MANAGER) |
| Mailing Address: | 1218 9th St Unit 2 Rupert |
| State: | ID US |
| Postal Code: | 833502207 |
| Phone Number: | 2083120957 |
| Fax Number: | |
| NPI Enumeration Date: | 04/14/2014 |
| NPI Last Update Date: | 04/14/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QH0700X |
| License Number: | AUD-1529 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ID |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Hearing and Speech |
| Taxonomy Definition: | An entity, facility, or distinct part of a facility providing diagnostic, treatment, prescriptive, and therapy services related to congenital and acquired conditions and diseases that affect hearing capacity and speech ability. |