Provider Demographics
NPI:1154520559
Name:EARMASTER, INC.
Entity type:Organization
Organization Name:EARMASTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:PENWRIGHT
Authorized Official - Suffix:JR
Authorized Official - Credentials:HIS
Authorized Official - Phone:580-436-3277
Mailing Address - Street 1:703 N BROADWAY AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:ADA
Mailing Address - State:OK
Mailing Address - Zip Code:74820-3457
Mailing Address - Country:US
Mailing Address - Phone:580-436-3277
Mailing Address - Fax:
Practice Address - Street 1:703 N BROADWAY AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:ADA
Practice Address - State:OK
Practice Address - Zip Code:74820-3457
Practice Address - Country:US
Practice Address - Phone:580-436-3277
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-16
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK595332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment