Provider Demographics
NPI:1386878197
Name:CORNELIUS HEARING AID CENTER
Entity type:Organization
Organization Name:CORNELIUS HEARING AID CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARILYN
Authorized Official - Middle Name:CORNELIUS
Authorized Official - Last Name:KERN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-323-7814
Mailing Address - Street 1:326 LOUISA ST
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSPORT
Mailing Address - State:PA
Mailing Address - Zip Code:17701-3221
Mailing Address - Country:US
Mailing Address - Phone:570-323-7814
Mailing Address - Fax:570-323-7814
Practice Address - Street 1:326 LOUISA ST
Practice Address - Street 2:
Practice Address - City:WILLIAMSPORT
Practice Address - State:PA
Practice Address - Zip Code:17701-3221
Practice Address - Country:US
Practice Address - Phone:570-323-7814
Practice Address - Fax:570-323-7814
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-07
Last Update Date:2009-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty