Provider Demographics
NPI:1730346040
Name:HARRELL'S HEARING SERVICES INC.
Entity type:Organization
Organization Name:HARRELL'S HEARING SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRELL
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:478-405-0330
Mailing Address - Street 1:3312 NORTHSIDE DR
Mailing Address - Street 2:ST. A 195
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31210-2500
Mailing Address - Country:US
Mailing Address - Phone:478-405-0330
Mailing Address - Fax:478-405-0600
Practice Address - Street 1:3312 NORTHSIDE DR
Practice Address - Street 2:ST. A 195
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31210-2500
Practice Address - Country:US
Practice Address - Phone:478-405-0330
Practice Address - Fax:478-405-0600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-22
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA000959231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP4914Medicare UPIN