Provider Demographics
NPI: | 1417307265 |
---|---|
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: | CRED SPECIALIST |
Authorized Official - Prefix: | |
Authorized Official - First Name: | LORI |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | MONSON |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 952-941-6401 |
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: | 512-858-2714 |
Practice Address - Street 1: | 350 NW EASTMAN PKWY |
Practice Address - Street 2: | |
Practice Address - City: | GRESHAM |
Practice Address - State: | OR |
Practice Address - Zip Code: | 97030-7203 |
Practice Address - Country: | US |
Practice Address - Phone: | 503-667-3832 |
Practice Address - Fax: | 503-465-4768 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2016-06-13 |
Last Update Date: | 2024-05-09 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 261QH0700X | Ambulatory Health Care Facilities | Clinic/Center | Hearing and Speech |
No | 332S00000X | Suppliers | Hearing Aid Equipment |