Provider Demographics
NPI:1649372129
Name:NORTHLAND AUDIOLOGY & HEARING SERV INC.
Entity type:Organization
Organization Name:NORTHLAND AUDIOLOGY & HEARING SERV INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:EILEEN
Authorized Official - Last Name:SHIMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-789-6780
Mailing Address - Street 1:PO BOX 32257
Mailing Address - Street 2:
Mailing Address - City:JUNEAU
Mailing Address - State:AK
Mailing Address - Zip Code:99803-2257
Mailing Address - Country:US
Mailing Address - Phone:907-789-6780
Mailing Address - Fax:907-789-5828
Practice Address - Street 1:8800 GLACIER HWY
Practice Address - Street 2:SUITE 116
Practice Address - City:JUNEAU
Practice Address - State:AK
Practice Address - Zip Code:99801-8087
Practice Address - Country:US
Practice Address - Phone:907-789-6780
Practice Address - Fax:907-789-5828
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-04
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty