Provider Demographics
NPI:1275074791
Name:RIVANNA HEARING CENTER LLC
Entity Type:Organization
Organization Name:RIVANNA HEARING CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:COOPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-244-3277
Mailing Address - Street 1:182 SPOTNAP RD
Mailing Address - Street 2:STE A2
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22911-8661
Mailing Address - Country:US
Mailing Address - Phone:434-244-3277
Mailing Address - Fax:
Practice Address - Street 1:182 SPOTNAP RD
Practice Address - Street 2:STE A2
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22911-8661
Practice Address - Country:US
Practice Address - Phone:434-244-3277
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-16
Last Update Date:2017-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Multi-Specialty