Healthcare Provider Details

I. General information

NPI: 1821364993
Provider Name (Legal Business Name): PJC COASTAL HEARING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2012
Last Update Date: 03/22/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

816 SPRING LAKE SQ
WINTER HAVEN FL
33881-1338
US

IV. Provider business mailing address

8416 OLD MCGREGOR RD
WACO TX
76712-6499
US

V. Phone/Fax

Practice location:
  • Phone: 863-293-0703
  • Fax: 863-293-0815
Mailing address:
  • Phone: 254-537-4422
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number
License Number State

VIII. Authorized Official

Name: PATRICK CURRY
Title or Position: OWNER
Credential:
Phone: 254-537-4422