Provider Demographics
NPI:1851893739
Name:COASTAL AUDITORY ASSOCIATES LLC.
Entity Type:Organization
Organization Name:COASTAL AUDITORY ASSOCIATES LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEARING AID SPECIALIST / MGR- MBR.
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:ROUSE
Authorized Official - Suffix:
Authorized Official - Credentials:HAS
Authorized Official - Phone:843-945-4046
Mailing Address - Street 1:1297 PROFESSIONAL DR STE 104
Mailing Address - Street 2:
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29577-5713
Mailing Address - Country:US
Mailing Address - Phone:843-945-4046
Mailing Address - Fax:843-712-1425
Practice Address - Street 1:1297 PROFESSIONAL DR STE 104
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29577-5713
Practice Address - Country:US
Practice Address - Phone:843-945-4046
Practice Address - Fax:843-712-1425
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-06
Last Update Date:2018-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment