Provider Demographics
NPI: | 1659721306 |
---|---|
Name: | NORTHLAND HEARING CENTERS, INC |
Entity Type: | Organization |
Organization Name: | NORTHLAND HEARING CENTERS, INC |
Other - Org Name: | WILLOUGHBY HEARING AID CENTERS |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | SENIOR DIRECTOR OF RETAIL OPERATION |
Authorized Official - Prefix: | |
Authorized Official - First Name: | MELONY |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | WINCHESTER |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 512-858-0300 |
Mailing Address - Street 1: | 26222 RANCH ROAD 12 |
Mailing Address - Street 2: | |
Mailing Address - City: | DRIPPING SPRINGS |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 78620-4903 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 512-858-0300 |
Mailing Address - Fax: | 512-858-2714 |
Practice Address - Street 1: | 358 WARNER MILNE RD STE G-100 |
Practice Address - Street 2: | |
Practice Address - City: | OREGON CITY |
Practice Address - State: | OR |
Practice Address - Zip Code: | 97045-4016 |
Practice Address - Country: | US |
Practice Address - Phone: | 503-655-8918 |
Practice Address - Fax: | 503-657-9242 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2016-06-14 |
Last Update Date: | 2016-06-14 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 332S00000X | Suppliers | Hearing Aid Equipment |