Provider Demographics
NPI:1104124825
Name:PREMIER HEARING II
Entity type:Organization
Organization Name:PREMIER HEARING II
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:SCHAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-526-4327
Mailing Address - Street 1:1111B LEXINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44907-2251
Mailing Address - Country:US
Mailing Address - Phone:419-526-4327
Mailing Address - Fax:
Practice Address - Street 1:1111B LEXINGTON AVE
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44907-2251
Practice Address - Country:US
Practice Address - Phone:419-526-4327
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-03
Last Update Date:2011-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH01996263332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment