Provider Demographics
NPI:1134669740
Name:EMANUELE HEARING HEALTHCARE LLC
Entity Type:Organization
Organization Name:EMANUELE HEARING HEALTHCARE LLC
Other - Org Name:MIRACLE EAR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AMBR/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:EMANUELE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-424-3121
Mailing Address - Street 1:3949 MULLENHURST DR
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34685-3666
Mailing Address - Country:US
Mailing Address - Phone:727-424-3121
Mailing Address - Fax:727-934-9197
Practice Address - Street 1:6783 VETERANS PKWY
Practice Address - Street 2:300 BLDG 4
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:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-01
Last Update Date:2017-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment