Provider Demographics
NPI:1114036837
Name:WILLIAMSPORT HEARING SERVICES, LLC
Entity Type:Organization
Organization Name:WILLIAMSPORT HEARING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:M
Authorized Official - Last Name:CHAMBERLIN
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:570-323-7000
Mailing Address - Street 1:1215 W SOUTHERN AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH WILLIAMSPORT
Mailing Address - State:PA
Mailing Address - Zip Code:17702-7142
Mailing Address - Country:US
Mailing Address - Phone:570-323-7000
Mailing Address - Fax:570-329-1055
Practice Address - Street 1:1215 W SOUTHERN AVE
Practice Address - Street 2:
Practice Address - City:SOUTH WILLIAMSPORT
Practice Address - State:PA
Practice Address - Zip Code:17702-7142
Practice Address - Country:US
Practice Address - Phone:570-323-7000
Practice Address - Fax:570-329-1055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAT000678L231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty