Provider Demographics
NPI:1801864962
Name:RIVERSIDE HEARING SERVICES
Entity Type:Organization
Organization Name:RIVERSIDE HEARING SERVICES
Other - Org Name:BELTONE HEARING AID CENTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:E
Authorized Official - Last Name:KOVACH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-796-1315
Mailing Address - Street 1:3 ALEXANDRIA CT
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17050-8224
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5405 JONESTOWN RD
Practice Address - Street 2:SUITE 109
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17112-4021
Practice Address - Country:US
Practice Address - Phone:717-540-4355
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPAD00240332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
PABE281401Medicare ID - Type Unspecified