Provider Demographics
NPI:1073939351
Name:HARTLAND HEARING AID CENTER INC
Entity type:Organization
Organization Name:HARTLAND HEARING AID CENTER INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:HARTWICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-539-4593
Mailing Address - Street 1:473 E POYNTZ AVE
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66502-5045
Mailing Address - Country:US
Mailing Address - Phone:785-539-4593
Mailing Address - Fax:785-539-4983
Practice Address - Street 1:473 E POYNTZ AVE
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502-5045
Practice Address - Country:US
Practice Address - Phone:785-539-4593
Practice Address - Fax:785-539-4983
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-11
Last Update Date:2016-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1549332S00000X
KS783332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100372900AMedicaid