Provider Demographics
NPI:1487064846
Name:EAST COAST HEARING AND BALANCE, INC.
Entity type:Organization
Organization Name:EAST COAST HEARING AND BALANCE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRACTITIONER
Authorized Official - Prefix:DR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:GAINES
Authorized Official - Suffix:II
Authorized Official - Credentials:AUD, PHD, CCC-A
Authorized Official - Phone:252-773-0636
Mailing Address - Street 1:5000 US HIGHWAY 70 W
Mailing Address - Street 2:SUITE 103
Mailing Address - City:MOREHEAD CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28557-4531
Mailing Address - Country:US
Mailing Address - Phone:919-302-7700
Mailing Address - Fax:
Practice Address - Street 1:5000 US HIGHWAY 70 W
Practice Address - Street 2:SUITE 103
Practice Address - City:MOREHEAD CITY
Practice Address - State:NC
Practice Address - Zip Code:28557-4531
Practice Address - Country:US
Practice Address - Phone:252-773-0636
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-06
Last Update Date:2016-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
231HA2400X, 231HA2500X, 237600000X
NC10758231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
No231HA2400XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology PractitionerGroup - Single Specialty
No231HA2500XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology SupplierGroup - Single Specialty
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty