Provider Demographics
NPI:1194706044
Name:RUUD'S HEARING AID SERVICE
Entity type:Organization
Organization Name:RUUD'S HEARING AID SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:M
Authorized Official - Last Name:RUUD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-429-0427
Mailing Address - Street 1:815 SW 30TH ST
Mailing Address - Street 2:
Mailing Address - City:PENDLETON
Mailing Address - State:OR
Mailing Address - Zip Code:97801-3912
Mailing Address - Country:US
Mailing Address - Phone:541-429-0427
Mailing Address - Fax:541-320-7176
Practice Address - Street 1:815 SW 30TH ST
Practice Address - Street 2:
Practice Address - City:PENDLETON
Practice Address - State:OR
Practice Address - Zip Code:97801-3912
Practice Address - Country:US
Practice Address - Phone:541-429-0427
Practice Address - Fax:541-320-7176
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-08
Last Update Date:2023-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORHAS-P-924167237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9035189Medicaid
OR172247Medicaid