Provider Demographics
NPI:1376814962
Name:CAROLINA FOREST HEARING CENTER, P.C.
Entity Type:Organization
Organization Name:CAROLINA FOREST HEARING CENTER, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:SHUMWAY
Authorized Official - Suffix:
Authorized Official - Credentials:AUD, CCC-A, FAAA
Authorized Official - Phone:843-903-0635
Mailing Address - Street 1:3885 RENEE DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29579-4372
Mailing Address - Country:US
Mailing Address - Phone:843-903-0635
Mailing Address - Fax:843-903-0636
Practice Address - Street 1:3885 RENEE DR
Practice Address - Street 2:SUITE 102
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29579-4372
Practice Address - Country:US
Practice Address - Phone:843-903-0635
Practice Address - Fax:843-903-0636
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-13
Last Update Date:2012-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3950237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty