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	License Number	License Number State
1	332S00000X	Hearing Aid Equipment
2	261QH0700X	Hearing and Speech Clinic/Center

General Provider Information

NPI Number	:	1619101821
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	:	2310 KIPLING ST
Second Line	:
City	:	LAKEWOOD
State	:	CO
Zip	:	80215-1524
Country	:	US
Telephone Number	:	303-237-2923
Fax Number	:	303-237-5113

Authorized Official
Title or Position	:	BILLING SPECIALIST
Name	:	MEE VANG
Credential	:
Telephone Number	:	952-828-9127

Provider Enumeration Date	:	05/04/2009
Last Update Date	:	05/08/2024

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