| Organization Name: | EARCARE OF PONCA CITY OUTREACH INC |
| NPI Number: | 1790947844 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | TIM BRECHEISEN (OWNER) |
| Mailing Address: | 2010 N 14th St Ponca City |
| State: | OK US |
| Postal Code: | 746011917 |
| Phone Number: | 5807189991 |
| Fax Number: | |
| NPI Enumeration Date: | 06/30/2008 |
| NPI Last Update Date: | 07/09/2008 |
| 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. |