Provider Demographics
NPI:1861364846
Name:SOUTH ATLANTIC HEARING LLC
Entity type:Organization
Organization Name:SOUTH ATLANTIC HEARING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:A
Authorized Official - Last Name:CORRIDORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-741-2182
Mailing Address - Street 1:9101 MIDLOTHIAN TPKE STE 625
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23235-5036
Mailing Address - Country:US
Mailing Address - Phone:804-378-9957
Mailing Address - Fax:
Practice Address - Street 1:9101 MIDLOTHIAN TPKE STE 625
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23235-5036
Practice Address - Country:US
Practice Address - Phone:804-378-9957
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-19
Last Update Date:2025-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Multi-Specialty