Healthcare Provider Details

I. General information

NPI: 1750712238
Provider Name (Legal Business Name): NORTHLAND HEARING CENTERS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2013
Last Update Date: 05/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8283 N PINE ISLAND RD
TAMARAC FL
33321-1541
US

IV. Provider business mailing address

8800 SE SUNNYSIDE RD STE 300N
CLACKAMAS OR
97015-5703
US

V. Phone/Fax

Practice location:
  • Phone: 954-721-0003
  • Fax:
Mailing address:
  • Phone: 281-286-2999
  • Fax: 512-607-4893

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number
License Number StateNULL

VIII. Authorized Official

Name: JENNIFER MELES
Title or Position: DIRECTOR OF FINANCE
Credential:
Phone: 952-947-4889