Provider Demographics
NPI:1366683567
Name:FAMILY HEARING AID CNTR.
Entity Type:Organization
Organization Name:FAMILY HEARING AID CNTR.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:EARL
Authorized Official - Last Name:TYNER
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:804-862-4000
Mailing Address - Street 1:1936 S. SYCAMORE ST.
Mailing Address - Street 2:
Mailing Address - City:PETERSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23805
Mailing Address - Country:US
Mailing Address - Phone:804-862-4000
Mailing Address - Fax:
Practice Address - Street 1:1936 S. SYCAMORE ST.
Practice Address - Street 2:
Practice Address - City:PETERSBURG
Practice Address - State:VA
Practice Address - Zip Code:23805
Practice Address - Country:US
Practice Address - Phone:804-862-4000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-18
Last Update Date:2009-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty