Provider Demographics
NPI:1154737286
Name:SOUTHEAST HEARING CENTERS, LLC
Entity type:Organization
Organization Name:SOUTHEAST HEARING CENTERS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:GREIVE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-707-1305
Mailing Address - Street 1:16 WILLIAM POPE DR., STE 103
Mailing Address - Street 2:
Mailing Address - City:BLUFFTON
Mailing Address - State:SC
Mailing Address - Zip Code:29909
Mailing Address - Country:US
Mailing Address - Phone:843-707-1305
Mailing Address - Fax:843-707-1311
Practice Address - Street 1:16 WILLIAM POPE DR., STE 103
Practice Address - Street 2:
Practice Address - City:BLUFFTON
Practice Address - State:SC
Practice Address - Zip Code:29909
Practice Address - Country:US
Practice Address - Phone:843-707-1305
Practice Address - Fax:843-707-1311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-09
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCHAS507237700000X
237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty