Provider Demographics
NPI:1881190957
Name:A1 AFFORDABLE HEARING LLC
Entity Type:Organization
Organization Name:A1 AFFORDABLE HEARING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEARING AID SPECIALIST
Authorized Official - Prefix:MR
Authorized Official - First Name:JAY
Authorized Official - Middle Name:BRYAN
Authorized Official - Last Name:NICHOLS
Authorized Official - Suffix:
Authorized Official - Credentials:BC-HIS
Authorized Official - Phone:252-342-1155
Mailing Address - Street 1:108 W FIRE TOWER RD STE G
Mailing Address - Street 2:
Mailing Address - City:WINTERVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28590-8408
Mailing Address - Country:US
Mailing Address - Phone:252-689-6020
Mailing Address - Fax:252-689-6029
Practice Address - Street 1:108 W FIRE TOWER RD STE G
Practice Address - Street 2:
Practice Address - City:WINTERVILLE
Practice Address - State:NC
Practice Address - Zip Code:28590-8408
Practice Address - Country:US
Practice Address - Phone:252-689-6020
Practice Address - Fax:252-689-6029
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-05
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1435237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC=========OtherAUDIOLOGY