1861108094 NPI number — HORNE HEARING CENTER PLLC

Table of content: (NPI 1861108094)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861108094 NPI number — HORNE HEARING CENTER PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HORNE HEARING CENTER PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1861108094
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/17/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
221 N PHOENIX AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RUSSELLVILLE
Provider Business Mailing Address State Name:
AR
Provider Business Mailing Address Postal Code:
72801-2825
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
479-886-0908
Provider Business Mailing Address Fax Number:
479-847-2737

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
221 N PHOENIX AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RUSSELLVILLE
Provider Business Practice Location Address State Name:
AR
Provider Business Practice Location Address Postal Code:
72801-2825
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
479-886-0908
Provider Business Practice Location Address Fax Number:
479-847-2737
Provider Enumeration Date:
01/31/2023

Additional Information

Authorized Official

Authorized Official Last Name:
HORNE
Authorized Official First Name:
RACHEL
Authorized Official Middle Name:
ELIZABETH
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
479-747-3774

Provider Taxonomy Codes

  • Taxonomy code: 231H00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1912227711 . This is a "BCBS" identifier , issued by the state of ( AR ) . This identifiers is of the category "OTHER".
  • Identifier: 1912227711 . This is a "AETNA" identifier , issued by the state of ( AR ) . This identifiers is of the category "OTHER".




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