Healthcare Provider Details

I. General information

NPI: 1134594948
Provider Name (Legal Business Name): NORTHLAND HEARING CENTERS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2015
Last Update Date: 12/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7301A W PALMETTO PARK RD SUITE 305A
BOCA RATON FL
33433-3466
US

IV. Provider business mailing address

1001 E. SUNSET ROAD UNIT 96595
LAS VEGAS NV
89193-1246
US

V. Phone/Fax

Practice location:
  • Phone: 561-393-6161
  • Fax: 561-393-5331
Mailing address:
  • Phone: 702-798-0113
  • Fax: 866-291-5242

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number201256229
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number
License Number State

VIII. Authorized Official

Name: STEVEN L RICHARDS
Title or Position: VICE PRESIDENT
Credential:
Phone: 800-328-8602