Provider Demographics
NPI:1821473786
Name:SOUTHEAST HEARING
Entity Type:Organization
Organization Name:SOUTHEAST HEARING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEARING INSTRUMENT SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-239-4103
Mailing Address - Street 1:315 JOHNNY MERCER BLVD
Mailing Address - Street 2:SUITE D
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31410-2224
Mailing Address - Country:US
Mailing Address - Phone:912-239-4103
Mailing Address - Fax:912-239-4107
Practice Address - Street 1:16 WILLIAM POPE DR
Practice Address - Street 2:SUITE 103
Practice Address - City:BLUFFTON
Practice Address - State:SC
Practice Address - Zip Code:29909-7502
Practice Address - Country:US
Practice Address - Phone:843-707-1305
Practice Address - Fax:843-707-1311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-21
Last Update Date:2015-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAHADS872332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment