Provider Demographics
NPI:1275991689
Name:COASTAL HEARING CLINIC INC.
Entity Type:Organization
Organization Name:COASTAL HEARING CLINIC INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHERI
Authorized Official - Middle Name:
Authorized Official - Last Name:MAGNACCA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-221-4549
Mailing Address - Street 1:74 LONG POND RD
Mailing Address - Street 2:1B
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-2605
Mailing Address - Country:US
Mailing Address - Phone:774-283-4770
Mailing Address - Fax:
Practice Address - Street 1:74 LONG POND RD
Practice Address - Street 2:1B
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-2605
Practice Address - Country:US
Practice Address - Phone:774-283-4770
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-01
Last Update Date:2016-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment