Provider Demographics
NPI: | 1245567056 |
---|---|
Name: | COASTAL HEARING SOLUTIONS, INC. |
Entity Type: | Organization |
Organization Name: | COASTAL HEARING SOLUTIONS, INC. |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | HEARING INSTURMENT SPEICALIST/PRESI |
Authorized Official - Prefix: | |
Authorized Official - First Name: | TERESA |
Authorized Official - Middle Name: | S |
Authorized Official - Last Name: | BOGGS |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | HIS |
Authorized Official - Phone: | 910-799-4327 |
Mailing Address - Street 1: | 2316 S 17TH ST |
Mailing Address - Street 2: | 160 |
Mailing Address - City: | WILMINGTON |
Mailing Address - State: | NC |
Mailing Address - Zip Code: | 28401-7911 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 910-799-4327 |
Mailing Address - Fax: | 910-799-4315 |
Practice Address - Street 1: | 2316 S 17TH ST |
Practice Address - Street 2: | 160 |
Practice Address - City: | WILMINGTON |
Practice Address - State: | NC |
Practice Address - Zip Code: | 28401-7911 |
Practice Address - Country: | US |
Practice Address - Phone: | 910-799-4327 |
Practice Address - Fax: | 910-799-4315 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2009-11-16 |
Last Update Date: | 2009-11-16 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
NC | 1198 | 332S00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 332S00000X | Suppliers | Hearing Aid Equipment |