Provider Demographics
NPI:1386069425
Name:BLAINE AUDIOLOGY & HEARING CENTER LLC
Entity type:Organization
Organization Name:BLAINE AUDIOLOGY & HEARING CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:OSBERG
Authorized Official - Last Name:BINFET
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:763-717-0072
Mailing Address - Street 1:7300 FRANCE AVE S
Mailing Address - Street 2:SUITE 100
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-4525
Mailing Address - Country:US
Mailing Address - Phone:952-922-2408
Mailing Address - Fax:
Practice Address - Street 1:10995 CLUB WEST PKWY STE 100
Practice Address - Street 2:
Practice Address - City:BLAINE
Practice Address - State:MN
Practice Address - Zip Code:55449-5859
Practice Address - Country:US
Practice Address - Phone:952-922-2408
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-26
Last Update Date:2015-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN8365231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty