Provider Demographics
NPI:1952832552
Name:NORTHLAND HEARING CENTERS, INC.
Entity Type:Organization
Organization Name:NORTHLAND HEARING CENTERS, INC.
Other - Org Name:NEWSOUND HEARING CENTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:PEDREGUERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-947-4602
Mailing Address - Street 1:6700 WASHINGTON AVE S
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55344-3405
Mailing Address - Country:US
Mailing Address - Phone:612-351-1529
Mailing Address - Fax:952-914-7931
Practice Address - Street 1:476 BROAD ST
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07003-2740
Practice Address - Country:US
Practice Address - Phone:973-473-6590
Practice Address - Fax:973-595-8818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-24
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
No332S00000XSuppliersHearing Aid Equipment