Provider Demographics
NPI:1104336437
Name:PINNACLE HEARING AID CENTER LLC
Entity type:Organization
Organization Name:PINNACLE HEARING AID CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:W
Authorized Official - Last Name:KREPS
Authorized Official - Suffix:
Authorized Official - Credentials:BC-HIS
Authorized Official - Phone:970-628-4927
Mailing Address - Street 1:759 HORIZON DR STE E
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81506-8737
Mailing Address - Country:US
Mailing Address - Phone:970-628-4927
Mailing Address - Fax:970-628-4925
Practice Address - Street 1:759 HORIZON DR STE E
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81506
Practice Address - Country:US
Practice Address - Phone:970-628-4927
Practice Address - Fax:970-628-4925
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-29
Last Update Date:2018-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COHAD.0000254237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty