Provider Demographics
NPI:1013931609
Name:NORTHVILLE HEARING AID CTR
Entity Type:Organization
Organization Name:NORTHVILLE HEARING AID CTR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:LIN
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:MCNAIR
Authorized Official - Suffix:
Authorized Official - Credentials:BC HIS ACA
Authorized Official - Phone:248-349-0657
Mailing Address - Street 1:18600 NORTHVILLE ROAD
Mailing Address - Street 2:STE 700
Mailing Address - City:NORTHVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48168
Mailing Address - Country:US
Mailing Address - Phone:248-349-0657
Mailing Address - Fax:248-348-8663
Practice Address - Street 1:18600 NORTHVILLE ROAD
Practice Address - Street 2:STE 700
Practice Address - City:NORTHVILLE
Practice Address - State:MI
Practice Address - Zip Code:48168
Practice Address - Country:US
Practice Address - Phone:248-349-0657
Practice Address - Fax:248-348-8663
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI3501002314332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment