Provider Demographics
NPI:1386902773
Name:ADVANCED HEARING CARE, LLC
Entity type:Organization
Organization Name:ADVANCED HEARING CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:M
Authorized Official - Last Name:FROST
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:575-521-9795
Mailing Address - Street 1:4351 E LOHMAN AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88011-8258
Mailing Address - Country:US
Mailing Address - Phone:575-527-9795
Mailing Address - Fax:
Practice Address - Street 1:4351 E LOHMAN AVE STE 103
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88011-8258
Practice Address - Country:US
Practice Address - Phone:575-521-9795
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-24
Last Update Date:2020-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1807231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty