MEDICARE: NORTHLAND HEARING CENTERS, INC.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	237700000X	Hearing Instrument Specialist
2	237600000X	Audiologist-Hearing Aid Fitter
3	261QH0700X	Hearing and Speech Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447305909
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTHLAND HEARING CENTERS, INC.

Provider Business Mailing Address
First Line	:	6700 WASHINGTON AVE S
Second Line	:
City	:	EDEN PRAIRIE
State	:	MN
Zip	:	55344-3405
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1245 FARMINGTON AVE STE 201
Second Line	:
City	:	WEST HARTFORD
State	:	CT
Zip	:	06107-2667
Country	:	US
Telephone Number	:	860-521-1213
Fax Number	:	860-561-5094

Authorized Official
Title or Position	:	REGIONAL SUPPORT SPECIALIST
Name	:	XUE XIONG
Credential	:
Telephone Number	:	763-292-4745

Provider Enumeration Date	:	01/24/2007
Last Update Date	:	05/07/2024

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