Provider Demographics
NPI:1386102010
Name:SHORE HEARING LLC
Entity type:Organization
Organization Name:SHORE HEARING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:MR
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:BUTLER
Authorized Official - Suffix:
Authorized Official - Credentials:H I S
Authorized Official - Phone:757-710-4224
Mailing Address - Street 1:PO BOX 1064
Mailing Address - Street 2:
Mailing Address - City:ONLEY
Mailing Address - State:VA
Mailing Address - Zip Code:23418-1064
Mailing Address - Country:US
Mailing Address - Phone:757-710-4224
Mailing Address - Fax:
Practice Address - Street 1:9502 HOSPITAL AVE.
Practice Address - Street 2:
Practice Address - City:NASSAWADOX
Practice Address - State:VA
Practice Address - Zip Code:23413
Practice Address - Country:US
Practice Address - Phone:757-710-4224
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-12
Last Update Date:2019-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty