Provider Demographics
NPI:1700647377
Name:SHORELINE HEARING AID CENTER
Entity Type:Organization
Organization Name:SHORELINE HEARING AID CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEARING SPECIALIST
Authorized Official - Prefix:MS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:O
Authorized Official - Last Name:BENNETT
Authorized Official - Suffix:
Authorized Official - Credentials:HEARING SPECIALIST
Authorized Official - Phone:252-622-4589
Mailing Address - Street 1:3328 BRIDGES ST STE D
Mailing Address - Street 2:
Mailing Address - City:MOREHEAD CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28557-3262
Mailing Address - Country:US
Mailing Address - Phone:252-622-4589
Mailing Address - Fax:
Practice Address - Street 1:3328 BRIDGES ST STE D
Practice Address - Street 2:
Practice Address - City:MOREHEAD CITY
Practice Address - State:NC
Practice Address - Zip Code:28557-3262
Practice Address - Country:US
Practice Address - Phone:252-622-4589
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-19
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty