Provider Demographics
| NPI: | 1194050237 |
|---|---|
| Name: | LITTLEFIELD COMPANY |
| Entity type: | Organization |
| Organization Name: | LITTLEFIELD COMPANY |
| Other - Org Name: | <UNAVAIL> |
| Other - Org Type: | |
| Authorized Official - Title/Position: | SECTREAS |
| Authorized Official - Prefix: | MR |
| Authorized Official - First Name: | MICHAEL |
| Authorized Official - Middle Name: | S |
| Authorized Official - Last Name: | LITTLEFIELD |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | HEARING INSTRUMENT S |
| Authorized Official - Phone: | 801-485-1441 |
| Mailing Address - Street 1: | 1441 E 2100 S |
| Mailing Address - Street 2: | |
| Mailing Address - City: | SALT LAKE CITY |
| Mailing Address - State: | UT |
| Mailing Address - Zip Code: | 84105-3724 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 801-485-1441 |
| Mailing Address - Fax: | 801-485-1480 |
| Practice Address - Street 1: | 1441 E 2100 S |
| Practice Address - Street 2: | |
| Practice Address - City: | SALT LAKE CITY |
| Practice Address - State: | UT |
| Practice Address - Zip Code: | 84105-3724 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 801-485-1441 |
| Practice Address - Fax: | 801-485-1480 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2009-10-07 |
| Last Update Date: | 2009-10-07 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization |
|---|---|---|---|---|
| Yes | 332S00000X | Suppliers | Hearing Aid Equipment |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| UT | =========003 | Medicaid |