Healthcare Provider Details

I. General information

NPI: 1295041226
Provider Name (Legal Business Name): DIGITAL HEARING AID OUTLET INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2010
Last Update Date: 08/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4206 SEBRING PKWY
SEBRING FL
33870-6610
US

IV. Provider business mailing address

4206 SEBRING PKWY
SEBRING FL
33870-6610
US

V. Phone/Fax

Practice location:
  • Phone: 863-382-9210
  • Fax: 863-382-9409
Mailing address:
  • Phone: 863-382-9210
  • Fax: 863-382-9409

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberAS3391
License Number StateFL

VIII. Authorized Official

Name: MR. CHARLES GEORGE OLIVER
Title or Position: OWNER
Credential: BC-HIS
Phone: 863-382-9210