Basic Information
| Provider Information | |||||||||
| NPI: | 1750436226 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ATLANTA HEARING AID SERVICES | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2655 N DECATUR RD STE D | ||||||||
| Address2: | SUBURBAN PLAZA | ||||||||
| City: | DECATUR | ||||||||
| State: | GA | ||||||||
| PostalCode: | 300336100 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4043732411 | ||||||||
| FaxNumber: | 4043700451 | ||||||||
| Practice Location | |||||||||
| Address1: | 2655 N DECATUR RD STE D | ||||||||
| Address2: | SUBURBAN PLAZA | ||||||||
| City: | DECATUR | ||||||||
| State: | GA | ||||||||
| PostalCode: | 300336100 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4043732411 | ||||||||
| FaxNumber: | 4043700451 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/24/2007 | ||||||||
| LastUpdateDate: | 03/27/2012 | ||||||||
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| AuthorizedOfficialLastName: | SEAGO | ||||||||
| AuthorizedOfficialFirstName: | SHARON | ||||||||
| AuthorizedOfficialMiddleName: | E. | ||||||||
| AuthorizedOfficialTitleorPosition: | MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 4043732411 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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| AuthorizedOfficialCredential: | BC-HIS | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 237700000X | 220 | GA | N | 193200000X MULTI-SPECIALTY GROUP | Speech, Language and Hearing Service Providers | Hearing Instrument Specialist | 237700000X | 153 | GA | Y | 193200000X MULTI-SPECIALTY GROUP | Speech, Language and Hearing Service Providers | Hearing Instrument Specialist |
No ID Information.