Provider Demographics
NPI:1427562289
Name:THE BEAUFORT SOUND
Entity Type:Organization
Organization Name:THE BEAUFORT SOUND
Other - Org Name:THE BEAUFORT SOUND, LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER / AUDIOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:E
Authorized Official - Last Name:BRIDGE
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:770-845-0751
Mailing Address - Street 1:206 SEA ISLAND PKWY STE 31
Mailing Address - Street 2:
Mailing Address - City:BEAUFORT
Mailing Address - State:SC
Mailing Address - Zip Code:29907-1526
Mailing Address - Country:US
Mailing Address - Phone:770-845-0751
Mailing Address - Fax:
Practice Address - Street 1:206 SEA ISLAND PKWY STE 31
Practice Address - Street 2:
Practice Address - City:BEAUFORT
Practice Address - State:SC
Practice Address - Zip Code:29907-1526
Practice Address - Country:US
Practice Address - Phone:770-845-0751
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-30
Last Update Date:2017-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCSC3979231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty