Provider Demographics
NPI:1215312897
Name:GLEN HEARING ASSOCIATES, LLC
Entity type:Organization
Organization Name:GLEN HEARING ASSOCIATES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:A
Authorized Official - Last Name:GLEN
Authorized Official - Suffix:
Authorized Official - Credentials:HAS
Authorized Official - Phone:513-895-4327
Mailing Address - Street 1:1001 E. SUNSET ROAD
Mailing Address - Street 2:UNIT 96595
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89193-1246
Mailing Address - Country:US
Mailing Address - Phone:702-798-0113
Mailing Address - Fax:866-291-5242
Practice Address - Street 1:3373 PRINCETON RD
Practice Address - Street 2:SUITE D117
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45011-5416
Practice Address - Country:US
Practice Address - Phone:513-895-4327
Practice Address - Fax:513-894-4327
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-24
Last Update Date:2016-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03273237600000X, 332S00000X
OH02225237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332S00000XSuppliersHearing Aid EquipmentGroup - Single Specialty
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty