Provider Demographics
NPI:1841651866
Name:SAM'S HEARING AID CENTER #6332
Entity type:Organization
Organization Name:SAM'S HEARING AID CENTER #6332
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:HEARING INSTRUMENT SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:FARYNA
Authorized Official - Suffix:
Authorized Official - Credentials:BC-HIS
Authorized Official - Phone:215-613-1201
Mailing Address - Street 1:1000 FRANKLIN MILLS CIR
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19154-3115
Mailing Address - Country:US
Mailing Address - Phone:215-613-1201
Mailing Address - Fax:
Practice Address - Street 1:1000 FRANKLIN MILLS CIR
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19154-3115
Practice Address - Country:US
Practice Address - Phone:215-613-1201
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-18
Last Update Date:2016-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAF03577332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment