Provider Demographics
NPI:1730251091
Name:MIRACLE EAR HEARING
Entity type:Organization
Organization Name:MIRACLE EAR HEARING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:ROY
Authorized Official - Last Name:CHIQUET
Authorized Official - Suffix:
Authorized Official - Credentials:HEARING AID DISPENSE
Authorized Official - Phone:530-889-8660
Mailing Address - Street 1:432 GRASS VALLEY HWY
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:CA
Mailing Address - Zip Code:95603-3714
Mailing Address - Country:US
Mailing Address - Phone:530-889-8660
Mailing Address - Fax:530-889-1634
Practice Address - Street 1:432 GRASS VALLEY HWY
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:CA
Practice Address - Zip Code:95603-3714
Practice Address - Country:US
Practice Address - Phone:530-889-8660
Practice Address - Fax:530-889-1634
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-14
Last Update Date:2008-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHA2358332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment