Basic Information
| Provider Information | |||||||||
| NPI: | 1467585315 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | NORTHLAND HEARING CENTERS, INC. | ||||||||
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| OtherOrganizationName: | THE HEARING AID CENTER | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6700 WASHINGTON AVE S | ||||||||
| Address2: | TECH II, CBO | ||||||||
| City: | EDEN PRAIRIE | ||||||||
| State: | MN | ||||||||
| PostalCode: | 553443405 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8003288602 | ||||||||
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| Practice Location | |||||||||
| Address1: | 22270 US HIGHWAY 72 STE B | ||||||||
| Address2: | |||||||||
| City: | ATHENS | ||||||||
| State: | AL | ||||||||
| PostalCode: | 356132604 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8003280602 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/13/2007 | ||||||||
| LastUpdateDate: | 08/15/2018 | ||||||||
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| AuthorizedOfficialLastName: | MELES | ||||||||
| AuthorizedOfficialFirstName: | JENNIFER | ||||||||
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| AuthorizedOfficialTitleorPosition: | DIRECTOR OF FINANCE | ||||||||
| AuthorizedOfficialTelephone: | 9529474889 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 237600000X | N | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Speech, Language and Hearing Service Providers | Audiologist-Hearing Aid Fitter | 332S00000X | N | Suppliers | Hearing Aid Equipment | 261QH0700X | Y | Ambulatory Health Care Facilities | Clinic/Center | Hearing and Speech |
No ID Information.