Organization
FAIRWAY HEARING CENTER L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIVONEY S MEHRER HIS (PRESIDENT/OWNER)
(267) 319-2767
Entity
Organization
Contact information
Practice address
32566 DOCS PL EXTENSION, UNIT 2, MILLVILLE, DE 19967-6959
(302) 251-8252
Mailing address
45 DOCS PLACE EXT, MILLVILLE, DE 19967-6751
(267) 319-2767
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
O3-0010283
DE STATE LICENSE
DE
Enumeration date
01/26/2022
Last updated
04/26/2022
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