Provider Demographics
NPI:1033741277
Name:ME PIVOT HOLDINGS LLC
Entity Type:Organization
Organization Name:ME PIVOT HOLDINGS LLC
Other - Org Name:MIRACLE-EAR CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KEN
Authorized Official - Middle Name:
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-268-4000
Mailing Address - Street 1:150 S 5TH ST STE 2300
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55402-4223
Mailing Address - Country:US
Mailing Address - Phone:763-268-4000
Mailing Address - Fax:
Practice Address - Street 1:6783 VETERANS PKWY
Practice Address - Street 2:BLDG 4, STE 300
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31909-3254
Practice Address - Country:US
Practice Address - Phone:706-576-9888
Practice Address - Fax:706-576-9928
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ME PIVOT HOLDINGS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-02-05
Last Update Date:2020-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty