Provider Demographics
NPI:1922381300
Name:ABC HEARING PROFESSIONALS LLC.
Entity Type:Organization
Organization Name:ABC HEARING PROFESSIONALS LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:SIMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-899-4415
Mailing Address - Street 1:2900 PEACHTREE RD NW STE 210
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305-2189
Mailing Address - Country:US
Mailing Address - Phone:404-869-3494
Mailing Address - Fax:404-869-3496
Practice Address - Street 1:2900 PEACHTREE RD NW STE 210
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30305-2189
Practice Address - Country:US
Practice Address - Phone:404-869-3494
Practice Address - Fax:404-869-3496
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-22
Last Update Date:2011-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAHADE034980332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment