Provider Demographics
NPI:1487791109
Name:PROFESSIONAL HEARING AID ASSOCIATES INC
Entity type:Organization
Organization Name:PROFESSIONAL HEARING AID ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:HARRY
Authorized Official - Middle Name:HOWARD
Authorized Official - Last Name:HILDERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-271-6966
Mailing Address - Street 1:5101 SW 21ST ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66604-4419
Mailing Address - Country:US
Mailing Address - Phone:785-271-6966
Mailing Address - Fax:785-272-6874
Practice Address - Street 1:5101 SW 21ST ST
Practice Address - Street 2:SUITE 100
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66604-4419
Practice Address - Country:US
Practice Address - Phone:785-271-6966
Practice Address - Fax:785-272-6874
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2017-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332S00000X, 231H00000X
KS482237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
No332S00000XSuppliersHearing Aid EquipmentGroup - Multi-Specialty
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100324410AMedicaid