Provider Demographics
NPI:1073849774
Name:A.D.H. ENTERTPRISES, LLC
Entity Type:Organization
Organization Name:A.D.H. ENTERTPRISES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/HEARING INSTRUMENT SPECIALIST
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:HAGEDORN
Authorized Official - Suffix:
Authorized Official - Credentials:BC-HIS
Authorized Official - Phone:410-553-9310
Mailing Address - Street 1:7678 QUARTERFIELD RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-7069
Mailing Address - Country:US
Mailing Address - Phone:410-553-9310
Mailing Address - Fax:410-553-0872
Practice Address - Street 1:7678 QUARTERFIELD RD
Practice Address - Street 2:SUITE 202
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-7069
Practice Address - Country:US
Practice Address - Phone:410-553-9310
Practice Address - Fax:410-553-0872
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-30
Last Update Date:2015-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDHAD1549332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDL352ADOtherBLUE CROSS BLUE SHIELD