1518494087 NPI number — HEAR CAROLINA AUDIOLOGY ASSOCIATES INC

Table of content: (NPI 1518494087)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518494087 NPI number — HEAR CAROLINA AUDIOLOGY ASSOCIATES INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HEAR CAROLINA AUDIOLOGY ASSOCIATES INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
SOUTHERN COAST AUDIOLOGY, INC
Provider Other Organization Name Type Code:
4
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1518494087
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/18/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4108 VANN DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LUMBERTON
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28358-2459
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
318-243-2611
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4310 LUDGATE ST STE A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LUMBERTON
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28358-2472
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-370-0118
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/16/2017

Additional Information

Authorized Official

Authorized Official Last Name:
BROWN
Authorized Official First Name:
BRITTANY
Authorized Official Middle Name:
S
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
910-370-0118

Provider Taxonomy Codes

  • Taxonomy code: 231H00000X , with the licence number:  9726 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 237600000X , with the licence number: 9726 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com