Provider Demographics
NPI:1841483906
Name:R L VAUGH ENTERPRISES DBA MIRACLE EAR
Entity type:Organization
Organization Name:R L VAUGH ENTERPRISES DBA MIRACLE EAR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MGR OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LORRAINE
Authorized Official - Middle Name:
Authorized Official - Last Name:VAUGHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-650-9987
Mailing Address - Street 1:PO BOX 70665
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89170
Mailing Address - Country:US
Mailing Address - Phone:702-650-9987
Mailing Address - Fax:702-965-9490
Practice Address - Street 1:3450 S MARYLAND PKWY
Practice Address - Street 2:MIRACLE EAR HEARING INSIDE SEARS
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89109
Practice Address - Country:US
Practice Address - Phone:702-650-9987
Practice Address - Fax:702-965-9490
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-22
Last Update Date:2007-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVH03000581120586332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment