Provider Demographics
NPI:1538548227
Name:3HOME SERVICE HEARING AID, INC.
Entity type:Organization
Organization Name:3HOME SERVICE HEARING AID, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER / CO-OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LYNETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:ONUMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-441-1278
Mailing Address - Street 1:8111 176TH LN NW
Mailing Address - Street 2:
Mailing Address - City:ANOKA
Mailing Address - State:MN
Mailing Address - Zip Code:55303-5570
Mailing Address - Country:US
Mailing Address - Phone:763-441-1278
Mailing Address - Fax:763-205-2099
Practice Address - Street 1:8111 176TH LN NW
Practice Address - Street 2:
Practice Address - City:ANOKA
Practice Address - State:MN
Practice Address - Zip Code:55303-5570
Practice Address - Country:US
Practice Address - Phone:763-441-1278
Practice Address - Fax:763-205-2099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-27
Last Update Date:2015-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1123118332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN757366900Medicaid