Provider Demographics
NPI:1023282431
Name:GALLAHERS HOUSE OF HEARING AIDS, INC
Entity type:Organization
Organization Name:GALLAHERS HOUSE OF HEARING AIDS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:WILBUR
Authorized Official - Last Name:GALLAHER
Authorized Official - Suffix:
Authorized Official - Credentials:BC-HIS
Authorized Official - Phone:314-352-7402
Mailing Address - Street 1:5010 HAMPTON AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63109-3111
Mailing Address - Country:US
Mailing Address - Phone:314-352-7402
Mailing Address - Fax:314-352-2520
Practice Address - Street 1:5010 HAMPTON AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63109-3111
Practice Address - Country:US
Practice Address - Phone:314-352-7402
Practice Address - Fax:314-352-2520
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-16
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO000202332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment