Provider Demographics
NPI:1528446655
Name:GOODMAN HEARING
Entity type:Organization
Organization Name:GOODMAN HEARING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ARNIE
Authorized Official - Middle Name:M
Authorized Official - Last Name:GOODMAN
Authorized Official - Suffix:
Authorized Official - Credentials:STATE LICENSE BC-HIS
Authorized Official - Phone:458-205-8968
Mailing Address - Street 1:816 BELTLINE RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OR
Mailing Address - Zip Code:97477-1091
Mailing Address - Country:US
Mailing Address - Phone:458-205-8968
Mailing Address - Fax:541-746-2625
Practice Address - Street 1:816 BELTLINE RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OR
Practice Address - Zip Code:97477-1091
Practice Address - Country:US
Practice Address - Phone:458-205-8968
Practice Address - Fax:541-746-2625
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-08
Last Update Date:2015-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORHAS-P 765408332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment