Provider Demographics
NPI:1891289757
Name:NOVA CUSTOM TECHNOLOGIES INC.
Entity Type:Organization
Organization Name:NOVA CUSTOM TECHNOLOGIES INC.
Other - Org Name:NOVA HEARING CENTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:SCHAEFFER
Authorized Official - Suffix:
Authorized Official - Credentials:HIS
Authorized Official - Phone:833-687-8324
Mailing Address - Street 1:600 N WITCHDUCK RD STE 103
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-1947
Mailing Address - Country:US
Mailing Address - Phone:833-687-8324
Mailing Address - Fax:833-687-8324
Practice Address - Street 1:600 N WITCHDUCK RD STE 103
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-1947
Practice Address - Country:US
Practice Address - Phone:833-687-8324
Practice Address - Fax:833-687-8324
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-14
Last Update Date:2020-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
No332S00000XSuppliersHearing Aid Equipment