Provider Demographics
NPI:1891098406
Name:EMERALD COAST HEARING ASSOCIATES, LLC
Entity Type:Organization
Organization Name:EMERALD COAST HEARING ASSOCIATES, LLC
Other - Org Name:EMERALD COAST HEARING ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JIM
Authorized Official - Middle Name:
Authorized Official - Last Name:DALY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-857-7487
Mailing Address - Street 1:339 RACETRACK RD NW STE 20
Mailing Address - Street 2:
Mailing Address - City:FORT WALTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32547-1581
Mailing Address - Country:US
Mailing Address - Phone:850-863-4327
Mailing Address - Fax:850-243-8741
Practice Address - Street 1:339 RACETRACK RD NW STE 20
Practice Address - Street 2:
Practice Address - City:FORT WALTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:32547-1581
Practice Address - Country:US
Practice Address - Phone:850-863-4327
Practice Address - Fax:850-243-8741
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-21
Last Update Date:2010-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty