Provider Demographics
NPI:1386041325
Name:HEAR BETTER HERE HEARING CENTER
Entity type:Organization
Organization Name:HEAR BETTER HERE HEARING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:LAVERNE
Authorized Official - Middle Name:C
Authorized Official - Last Name:WILLSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-355-9776
Mailing Address - Street 1:2525 W MAIN ST STE 106
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57702-2438
Mailing Address - Country:US
Mailing Address - Phone:605-355-9776
Mailing Address - Fax:
Practice Address - Street 1:2525 W MAIN ST STE 106
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57702-2438
Practice Address - Country:US
Practice Address - Phone:605-355-9776
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-19
Last Update Date:2014-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD257332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD1275793853Medicaid