Provider Demographics
NPI:1306296132
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:SR MGR CONTRACTING & CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:LOUISA
Authorized Official - Middle Name:EIFRIG
Authorized Official - Last Name:RAUTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-947-4983
Mailing Address - Street 1:6700 WASHINGTON AVE S
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55344-3405
Mailing Address - Country:US
Mailing Address - Phone:800-328-8602
Mailing Address - Fax:
Practice Address - Street 1:3759 FM 1488 RD STE 175
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77384-3999
Practice Address - Country:US
Practice Address - Phone:281-465-9111
Practice Address - Fax:281-465-8214
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-13
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
No332S00000XSuppliersHearing Aid Equipment