Provider Demographics
NPI:1225203243
Name:WITTKO HEARING AID CENTER,LTD
Entity Type:Organization
Organization Name:WITTKO HEARING AID CENTER,LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:C
Authorized Official - Last Name:WITTKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-249-9675
Mailing Address - Street 1:1550 HWY 17 NORTH
Mailing Address - Street 2:
Mailing Address - City:NORTH MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29582
Mailing Address - Country:US
Mailing Address - Phone:843-249-9675
Mailing Address - Fax:843-249-4697
Practice Address - Street 1:1550 HIGHWAY 17 N
Practice Address - Street 2:
Practice Address - City:NORTH MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29582-2552
Practice Address - Country:US
Practice Address - Phone:843-249-9675
Practice Address - Fax:843-249-4697
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-30
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC408332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC408OtherHEARING AID SPECIALIST