Provider Demographics
NPI:1508061441
Name:ADVANCED HEARING CARE ,INC
Entity Type:Organization
Organization Name:ADVANCED HEARING CARE ,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BRETON
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:508-559-9200
Mailing Address - Street 1:824 OAK ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02301-1180
Mailing Address - Country:US
Mailing Address - Phone:508-559-9200
Mailing Address - Fax:508-559-0027
Practice Address - Street 1:824 OAK ST
Practice Address - Street 2:SUITE 102
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301-1180
Practice Address - Country:US
Practice Address - Phone:508-559-9200
Practice Address - Fax:508-559-0027
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA160231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA680470OtherTUFTS
MA5102294Medicaid
MAAG0003OtherBLUE CROSS BLUE SHIELD
MA680470OtherTUFTS