Provider Demographics
NPI:1528823978
Name:CAROLINA FOREST HEARING CENTER OF SC LLC
Entity type:Organization
Organization Name:CAROLINA FOREST HEARING CENTER OF SC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:VAN NESS
Authorized Official - Suffix:
Authorized Official - Credentials:HAS
Authorized Official - Phone:843-903-0635
Mailing Address - Street 1:3885 RENEE DR STE 102
Mailing Address - Street 2:
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29579-4372
Mailing Address - Country:US
Mailing Address - Phone:843-903-0635
Mailing Address - Fax:843-903-0636
Practice Address - Street 1:3885 RENEE DR STE 102
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29579-4372
Practice Address - Country:US
Practice Address - Phone:843-903-0635
Practice Address - Fax:843-903-0636
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-15
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty