1902113814 NPI number — NORTHLAND HEARING CENTERS INC

Table of content: (NPI 1902113814)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902113814 NPI number — NORTHLAND HEARING CENTERS INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NORTHLAND HEARING CENTERS 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:
SEARS HEARING AID CENTERS
Provider Other Organization Name Type Code:
3
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:
1902113814
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/13/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10570 SE WASHINGTON ST
Provider Second Line Business Mailing Address:
SUITE 210
Provider Business Mailing Address City Name:
PORTLAND
Provider Business Mailing Address State Name:
OR
Provider Business Mailing Address Postal Code:
97216-2846
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
503-257-6800
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6909 E RENO AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MIDWEST CITY
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
73110-2151
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
405-869-0080
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/13/2010

Additional Information

Authorized Official

Authorized Official Last Name:
NELSON
Authorized Official First Name:
SCOTT
Authorized Official Middle Name:
Authorized Official Title or Position:
VP FINANCE
Authorized Official Telephone Number:
952-828-9120

Provider Taxonomy Codes

  • Taxonomy code: 231H00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 237600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 237700000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





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