Provider Demographics
NPI:1639447600
Name:ATLANTIC HEARING CENTERS, INC
Entity Type:Organization
Organization Name:ATLANTIC HEARING CENTERS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEARING AID DISPENSER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:BRISBANE
Authorized Official - Suffix:
Authorized Official - Credentials:HIS
Authorized Official - Phone:301-933-9377
Mailing Address - Street 1:10400 CONNECTICUT AVE
Mailing Address - Street 2:SUITE 510
Mailing Address - City:KENSINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20895-3910
Mailing Address - Country:US
Mailing Address - Phone:301-933-9377
Mailing Address - Fax:301-933-8755
Practice Address - Street 1:10400 CONNECTICUT AVE
Practice Address - Street 2:SUITE 510
Practice Address - City:KENSINGTON
Practice Address - State:MD
Practice Address - Zip Code:20895-3910
Practice Address - Country:US
Practice Address - Phone:301-933-9377
Practice Address - Fax:301-933-8755
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-06
Last Update Date:2011-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD2421332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment