Provider Demographics
NPI: | 1730224213 |
---|---|
Name: | NORTHLAND HEARING CENTERS, INC. |
Entity type: | Organization |
Organization Name: | NORTHLAND HEARING CENTERS, INC. |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | VP FINANCE |
Authorized Official - Prefix: | |
Authorized Official - First Name: | SCOTT |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | NELSON |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 952-828-9120 |
Mailing Address - Street 1: | 10570 SE WASHINGTON ST |
Mailing Address - Street 2: | SUITE 202 |
Mailing Address - City: | PORTLAND |
Mailing Address - State: | OR |
Mailing Address - Zip Code: | 97216-2846 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 503-257-6800 |
Mailing Address - Fax: | 503-257-6810 |
Practice Address - Street 1: | 823 DAVIDSON DR NW |
Practice Address - Street 2: | |
Practice Address - City: | CONCORD |
Practice Address - State: | NC |
Practice Address - Zip Code: | 28025-4351 |
Practice Address - Country: | US |
Practice Address - Phone: | 704-786-9297 |
Practice Address - Fax: | 704-793-1388 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2007-02-21 |
Last Update Date: | 2020-08-22 |
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 - Single Specialty |