Provider Demographics
NPI:1194268896
Name:NORTHLAND HEARING CENTERS, INC.
Entity type:Organization
Organization Name:NORTHLAND HEARING CENTERS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SENIOR DIRECTOR OF RETAIL OPERATION
Authorized Official - Prefix:
Authorized Official - First Name:MELONY
Authorized Official - Middle Name:
Authorized Official - Last Name:WINCHESTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-286-2999
Mailing Address - Street 1:6425 FLYING CLOUD DR
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55344-3305
Mailing Address - Country:US
Mailing Address - Phone:281-286-2999
Mailing Address - Fax:512-607-4893
Practice Address - Street 1:609 MAIN AVE
Practice Address - Street 2:
Practice Address - City:BROOKINGS
Practice Address - State:SD
Practice Address - Zip Code:57006-1424
Practice Address - Country:US
Practice Address - Phone:507-532-1024
Practice Address - Fax:507-829-9489
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-29
Last Update Date:2016-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment