Provider Demographics
NPI:1386880466
Name:AMY SWAIN HEARING CENTERS, LLC
Entity type:Organization
Organization Name:AMY SWAIN HEARING CENTERS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AMY
Authorized Official - Middle Name:CAROL
Authorized Official - Last Name:SWAIN
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:507-451-3879
Mailing Address - Street 1:685 W BRIDGE ST STE 3
Mailing Address - Street 2:
Mailing Address - City:OWATONNA
Mailing Address - State:MN
Mailing Address - Zip Code:55060-2888
Mailing Address - Country:US
Mailing Address - Phone:507-451-3879
Mailing Address - Fax:866-773-5194
Practice Address - Street 1:685 W BRIDGE ST STE 1B
Practice Address - Street 2:
Practice Address - City:OWATONNA
Practice Address - State:MN
Practice Address - Zip Code:55060-2889
Practice Address - Country:US
Practice Address - Phone:507-451-3879
Practice Address - Fax:866-773-5194
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-19
Last Update Date:2017-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5460332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN187265600Medicare UPIN