Provider Demographics
NPI:1720060452
Name:SOUTHERN HEARING ASSOCIATES, INC.
Entity type:Organization
Organization Name:SOUTHERN HEARING ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:D
Authorized Official - Last Name:TOOMEY
Authorized Official - Suffix:
Authorized Official - Credentials:BC-HIS
Authorized Official - Phone:334-393-6688
Mailing Address - Street 1:PO BOX 310901
Mailing Address - Street 2:
Mailing Address - City:ENTERPRISE
Mailing Address - State:AL
Mailing Address - Zip Code:36331-0901
Mailing Address - Country:US
Mailing Address - Phone:334-393-6688
Mailing Address - Fax:334-393-7011
Practice Address - Street 1:107 E WATTS ST
Practice Address - Street 2:
Practice Address - City:ENTERPRISE
Practice Address - State:AL
Practice Address - Zip Code:36330-2511
Practice Address - Country:US
Practice Address - Phone:334-393-6688
Practice Address - Fax:334-393-7011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-17
Last Update Date:2013-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4124237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty