Basic Information
| Provider Information | |||||||||
| NPI: | 1417193335 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | AURILINK, LLC | ||||||||
| LastName: | |||||||||
| FirstName: | |||||||||
| MiddleName: | |||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | |||||||||
| OtherOrganizationName: | HEAR-RITE | ||||||||
| OtherOrganizationType: | 3 | ||||||||
| OtherLastName: | |||||||||
| OtherFirstName: | |||||||||
| OtherMiddleName: | |||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | |||||||||
| OtherLastNameType: | |||||||||
| Mailing Information | |||||||||
| Address1: | 627 CHEROKEE ST | ||||||||
| Address2: | SUITE 9 | ||||||||
| City: | MARIETTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 300607245 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7705908662 | ||||||||
| FaxNumber: | 7704242009 | ||||||||
| Practice Location | |||||||||
| Address1: | 627 CHEROKEE ST | ||||||||
| Address2: | SUITE 9 | ||||||||
| City: | MARIETTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 300607245 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7705908662 | ||||||||
| FaxNumber: | 7704242009 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/23/2008 | ||||||||
| LastUpdateDate: | 04/03/2012 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
| NPIDeactivationDate: | |||||||||
| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | WHITCOMB | ||||||||
| AuthorizedOfficialFirstName: | OTIS | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | LICENSED HEARING AID DISPENCR/OWNER | ||||||||
| AuthorizedOfficialTelephone: | 7705908662 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | MR. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | MA | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332S00000X | AUD003621 | GA | N | Suppliers | Hearing Aid Equipment | 332S00000X | 671 | GA | Y | Suppliers | Hearing Aid Equipment |
No ID Information.