Provider Demographics
NPI:1275876179
Name:ADVANCED HEARING CENTER
Entity Type:Organization
Organization Name:ADVANCED HEARING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/AU.D
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:T
Authorized Official - Last Name:COPE
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:865-984-7750
Mailing Address - Street 1:821 ROSS DR
Mailing Address - Street 2:
Mailing Address - City:MARYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37801-8513
Mailing Address - Country:US
Mailing Address - Phone:865-984-7750
Mailing Address - Fax:865-984-7211
Practice Address - Street 1:821 ROSS DR
Practice Address - Street 2:
Practice Address - City:MARYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37801-8513
Practice Address - Country:US
Practice Address - Phone:865-984-7750
Practice Address - Fax:865-984-7211
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-29
Last Update Date:2013-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN231H00000X, 237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3192786Medicaid
TN3192786Medicaid