Provider Demographics
NPI:1316491384
Name:HEAR ON THE SHORE, INC.
Entity type:Organization
Organization Name:HEAR ON THE SHORE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KARLA
Authorized Official - Middle Name:K
Authorized Official - Last Name:QUILLEN
Authorized Official - Suffix:
Authorized Official - Credentials:HIS
Authorized Official - Phone:443-235-4461
Mailing Address - Street 1:103 BRYAN DR
Mailing Address - Street 2:
Mailing Address - City:REHOBOTH BEACH
Mailing Address - State:DE
Mailing Address - Zip Code:19971-9731
Mailing Address - Country:US
Mailing Address - Phone:443-235-4461
Mailing Address - Fax:
Practice Address - Street 1:119 W 3RD ST
Practice Address - Street 2:
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958-1315
Practice Address - Country:US
Practice Address - Phone:443-235-4461
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-08
Last Update Date:2016-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE030000251332S00000X
MD02731332S00000X
VA2102002685332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment