Provider Demographics
NPI:1306983713
Name:BLACK'S HEARING AID SERVICES, INC.
Entity type:Organization
Organization Name:BLACK'S HEARING AID SERVICES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:BLACK
Authorized Official - Suffix:
Authorized Official - Credentials:BC-HIS, ACA
Authorized Official - Phone:513-424-4851
Mailing Address - Street 1:500 S BREIEL BLVD STE E1
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:OH
Mailing Address - Zip Code:45044-5149
Mailing Address - Country:US
Mailing Address - Phone:513-424-4851
Mailing Address - Fax:513-424-5083
Practice Address - Street 1:500 S BREIEL BLVD STE E1
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:OH
Practice Address - Zip Code:45044-5149
Practice Address - Country:US
Practice Address - Phone:513-424-4851
Practice Address - Fax:513-424-5083
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-01
Last Update Date:2007-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2439332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000344450Medicare UPIN