Provider Demographics
NPI: | 1700156767 |
---|---|
Name: | NORTHLAND HEARING CENTERS, INC. |
Entity Type: | Organization |
Organization Name: | NORTHLAND HEARING CENTERS, INC. |
Other - Org Name: | PIN DROP HEARING |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | PRESIDENT |
Authorized Official - Prefix: | |
Authorized Official - First Name: | JEFFREY |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | LONGTAIN |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 503-659-5115 |
Mailing Address - Street 1: | 8800 SE SUNNYSIDE RD |
Mailing Address - Street 2: | STE 300-N |
Mailing Address - City: | CLACKAMAS |
Mailing Address - State: | OR |
Mailing Address - Zip Code: | 97015-5738 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 503-659-5115 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 12730 S BLACKBOB RD |
Practice Address - Street 2: | |
Practice Address - City: | OLATHE |
Practice Address - State: | KS |
Practice Address - Zip Code: | 66062-1409 |
Practice Address - Country: | US |
Practice Address - Phone: | 913-782-2546 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2012-01-09 |
Last Update Date: | 2012-01-09 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 237600000X | Speech, Language and Hearing Service Providers | Audiologist-Hearing Aid Fitter | Group - Multi-Specialty |