Provider Demographics
NPI:1376948091
Name:AMBIT HEARING AID CENTERS
Entity Type:Organization
Organization Name:AMBIT HEARING AID CENTERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:O'BRYAN
Authorized Official - Last Name:PEPPER
Authorized Official - Suffix:
Authorized Official - Credentials:HIS
Authorized Official - Phone:770-534-4150
Mailing Address - Street 1:1636 OAKBROOK DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30507-8492
Mailing Address - Country:US
Mailing Address - Phone:770-534-4150
Mailing Address - Fax:
Practice Address - Street 1:1636 OAKBROOK DR
Practice Address - Street 2:SUITE B
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30507-8492
Practice Address - Country:US
Practice Address - Phone:770-534-4150
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-23
Last Update Date:2014-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAHADE034823237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAHADE034823OtherHEARING AID DISPENSER