MEDICARE: MR. WILLIAM THOMAS ROUSE H.I.S.

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	237700000X	Hearing Instrument Specialist	HAS-0620	SC
2	237700000X	Hearing Instrument Specialist	1324	NC

General Provider Information

NPI Number	:	1750689790
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. WILLIAM THOMAS ROUSE H.I.S.

Provider Business Mailing Address
First Line	:	918 HALSTEAD BLVD
Second Line	:	SUITE E
City	:	ELIZABETH CITY
State	:	NC
Zip	:	27909-7036
Country	:	US
Telephone Number	:	252-337-7500
Fax Number	:	252-337-7400

Provider Business Practice Location Address
First Line	:	1294 PROFESSIONAL DR STE C
Second Line	:
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29577-5753
Country	:	US
Telephone Number	:	843-213-0099
Fax Number	:	843-213-0200

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/28/2011
Last Update Date	:	07/21/2022

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