Provider Demographics
NPI:1083931695
Name:NORTHLAND HEARING CENTERS INC
Entity Type:Organization
Organization Name:NORTHLAND HEARING CENTERS INC
Other - Org Name:CUMMING HEARING AID CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:L
Authorized Official - Last Name:LONGTAIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-257-6800
Mailing Address - Street 1:10570 SE WAHINGTON ST STE 210
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97216
Mailing Address - Country:US
Mailing Address - Phone:503-257-6800
Mailing Address - Fax:
Practice Address - Street 1:309 PIRKLE FERRY RD
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040-2545
Practice Address - Country:US
Practice Address - Phone:770-889-7600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-23
Last Update Date:2010-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty