Provider Demographics
NPI:1902837594
Name:NORTHLAND HEARING CENTET INC
Entity Type:Organization
Organization Name:NORTHLAND HEARING CENTET INC
Other - Org Name:TRINITY HEARING AID
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:H
Authorized Official - Last Name:FYKE
Authorized Official - Suffix:
Authorized Official - Credentials:FAAA, AUDIOLOGIST
Authorized Official - Phone:412-351-9190
Mailing Address - Street 1:2140 ARDMORE BLVD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15221-4860
Mailing Address - Country:US
Mailing Address - Phone:412-351-9190
Mailing Address - Fax:412-351-3586
Practice Address - Street 1:2140 ARDMORE BLVD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15221-4860
Practice Address - Country:US
Practice Address - Phone:412-351-9190
Practice Address - Fax:412-351-3586
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA290640Medicare ID - Type Unspecified