Provider Demographics
NPI:1194967505
Name:HEARING CARE SPECIALISTS INC
Entity type:Organization
Organization Name:HEARING CARE SPECIALISTS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JESSIE
Authorized Official - Middle Name:
Authorized Official - Last Name:FREDINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-931-9144
Mailing Address - Street 1:10417 EXCELSIOR BLVD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:HOPKINS
Mailing Address - State:MN
Mailing Address - Zip Code:55343-3421
Mailing Address - Country:US
Mailing Address - Phone:952-931-9144
Mailing Address - Fax:
Practice Address - Street 1:10417 EXCELSIOR BLVD
Practice Address - Street 2:SUITE 2
Practice Address - City:HOPKINS
Practice Address - State:MN
Practice Address - Zip Code:55343-3421
Practice Address - Country:US
Practice Address - Phone:952-931-9144
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-31
Last Update Date:2009-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5489237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
4500793OtherMEDICA
MN5G606HEOtherBCBS OF MN