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NPI Code Detail

MEDICARE: GULF COAST HEARING LLC

MEDICARE: GULF COAST HEARING LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1332BC3200XCustomized Equipment (DME)
2332S00000XHearing Aid Equipment
3261QH0700XHearing and Speech Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11467592501OTHERFLTIM SMITH NPI

General Provider Information

NPI Number : 1003589151
Entity Type Code : Organization
Provider Name (Legal Business Name) : GULF COAST HEARING LLC
Provider Business Mailing Address
First Line : 2232 SAINT ANDREWS BLVD
Second Line :
City : PANAMA CITY
State : FL
Zip : 32405-2158
Country : US
Telephone Number : 850-784-4327
Fax Number : 850-784-0060
Provider Business Practice Location Address
First Line : 2232 SAINT ANDREWS BLVD
Second Line :
City : PANAMA CITY
State : FL
Zip : 32405-2158
Country : US
Telephone Number : 850-784-4327
Fax Number : 850-784-0060
Authorized Official
Title or Position : PRESIDENT
Name : TIMOTHY B SMITH
Credential : HAS, BC-HIS
Telephone Number : 850-819-1240
Provider Enumeration Date : 07/26/2021
Last Update Date : 07/26/2021

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Directions to “GULF COAST HEARING LLC ” Practice Location

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