Provider Demographics
NPI:1104214840
Name:COASTAL HEARING, INC.
Entity type:Organization
Organization Name:COASTAL HEARING, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLHOUSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-216-6975
Mailing Address - Street 1:W3989 HOFA PARK RD
Mailing Address - Street 2:
Mailing Address - City:PULASKI
Mailing Address - State:WI
Mailing Address - Zip Code:54162-8484
Mailing Address - Country:US
Mailing Address - Phone:727-827-2990
Mailing Address - Fax:727-827-2990
Practice Address - Street 1:10825 102ND AVE
Practice Address - Street 2:
Practice Address - City:SEMINOLE
Practice Address - State:FL
Practice Address - Zip Code:33778-4208
Practice Address - Country:US
Practice Address - Phone:727-827-2990
Practice Address - Fax:727-827-2990
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-05
Last Update Date:2015-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment