| Organization Name: | EARCARE OF PONCA CITY, INC. |
| NPI Number: | 1669548533 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | TIM BRECHEISEN (OWNER) |
| Mailing Address: | 2010 North 14th Ponca City |
| State: | OK US |
| Postal Code: | 74601 |
| Phone Number: | 5807189991 |
| Fax Number: | 5807189993 |
| NPI Enumeration Date: | 11/24/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332S00000X |
| License Number: | CE569 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KS |
| 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. |