Provider Demographics
NPI:1891489498
Name:WYOMING HEARING AID CENTER LLC
Entity type:Organization
Organization Name:WYOMING HEARING AID CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ANNETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:FRERICHS
Authorized Official - Suffix:
Authorized Official - Credentials:HIS
Authorized Official - Phone:308-631-1636
Mailing Address - Street 1:PO BOX 599
Mailing Address - Street 2:
Mailing Address - City:BAYARD
Mailing Address - State:NE
Mailing Address - Zip Code:69334
Mailing Address - Country:US
Mailing Address - Phone:308-631-1636
Mailing Address - Fax:
Practice Address - Street 1:801 E 4TH ST
Practice Address - Street 2:SUITE 14
Practice Address - City:GILETTE
Practice Address - State:WY
Practice Address - Zip Code:82716
Practice Address - Country:US
Practice Address - Phone:308-689-4298
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-06
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty