MEDICARE: GIBBS HALL HEARING AID CENTER 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
1	332S00000X	Hearing Aid Equipment	1048	NC

General Provider Information

NPI Number	:	1821361734
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GIBBS HALL HEARING AID CENTER LLC

Provider Business Mailing Address
First Line	:	3334 WELLONS BLVD
Second Line	:
City	:	NEW BERN
State	:	NC
Zip	:	28562-5290
Country	:	US
Telephone Number	:	252-633-4327
Fax Number	:	252-633-4330

Provider Business Practice Location Address
First Line	:	3334 WELLONS BLVD
Second Line	:
City	:	NEW BERN
State	:	NC
Zip	:	28562-5290
Country	:	US
Telephone Number	:	252-633-4327
Fax Number	:	252-633-4330

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. SCARLET GIBBS HALL
Credential	:
Telephone Number	:	252-633-4327

Provider Enumeration Date	:	02/23/2012
Last Update Date	:	02/23/2012

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