Provider Demographics
NPI:1285099861
Name:HORIZON HEARING SERVICES
Entity type:Organization
Organization Name:HORIZON HEARING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALISHA
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:PURDUN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:660-425-7400
Mailing Address - Street 1:1101 S 25TH ST
Mailing Address - Street 2:P.O. BOX 503
Mailing Address - City:BETHANY
Mailing Address - State:MO
Mailing Address - Zip Code:64424-2611
Mailing Address - Country:US
Mailing Address - Phone:660-425-7400
Mailing Address - Fax:660-425-7404
Practice Address - Street 1:1101 S 25TH ST
Practice Address - Street 2:
Practice Address - City:BETHANY
Practice Address - State:MO
Practice Address - Zip Code:64424-2611
Practice Address - Country:US
Practice Address - Phone:660-425-7400
Practice Address - Fax:660-425-7404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-23
Last Update Date:2015-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOHG01305237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1770578635Medicaid
MO1770578635Medicaid