Provider Demographics
NPI:1598805913
Name:GULF COAST HEARING CENTERS, INC.
Entity Type:Organization
Organization Name:GULF COAST HEARING CENTERS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:W
Authorized Official - Last Name:DAME
Authorized Official - Suffix:
Authorized Official - Credentials:BC-HIS
Authorized Official - Phone:850-784-4327
Mailing Address - Street 1:2232 SAINT ANDREWS BLVD
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32405-2158
Mailing Address - Country:US
Mailing Address - Phone:850-784-4327
Mailing Address - Fax:850-784-0060
Practice Address - Street 1:2232 SAINT ANDREWS BLVD
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32405-2158
Practice Address - Country:US
Practice Address - Phone:850-784-4327
Practice Address - Fax:850-784-0060
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAS1565332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL085527800Medicaid