Provider Demographics
NPI:1689493074
Name:PIONEER HEARING AND TINNITUS LLC
Entity type:Organization
Organization Name:PIONEER HEARING AND TINNITUS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:O'NEIL
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:208-589-1548
Mailing Address - Street 1:215 E CEDAR ST STE D
Mailing Address - Street 2:
Mailing Address - City:POCATELLO
Mailing Address - State:ID
Mailing Address - Zip Code:83201-3700
Mailing Address - Country:US
Mailing Address - Phone:208-775-2255
Mailing Address - Fax:
Practice Address - Street 1:215 E CEDAR ST STE D
Practice Address - Street 2:
Practice Address - City:POCATELLO
Practice Address - State:ID
Practice Address - Zip Code:83201-3700
Practice Address - Country:US
Practice Address - Phone:208-589-1548
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-03
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty