Provider Demographics
NPI:1679693717
Name:HEARING COUNSELORS AND AUDIOLOGISTS, INC
Entity type:Organization
Organization Name:HEARING COUNSELORS AND AUDIOLOGISTS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:GREG
Authorized Official - Middle Name:A
Authorized Official - Last Name:SCHROEDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-733-0601
Mailing Address - Street 1:1239 POLE LINE RD E STE 314C
Mailing Address - Street 2:
Mailing Address - City:TWIN FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83301-3469
Mailing Address - Country:US
Mailing Address - Phone:208-733-0601
Mailing Address - Fax:208-733-0604
Practice Address - Street 1:1239 POLE LINE RD E STE 314C
Practice Address - Street 2:
Practice Address - City:TWIN FALLS
Practice Address - State:ID
Practice Address - Zip Code:83301-3469
Practice Address - Country:US
Practice Address - Phone:208-733-0601
Practice Address - Fax:208-733-0604
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-30
Last Update Date:2013-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDHA-263231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID1679693717Medicare NSC