Healthcare Provider Details

I. General information

NPI: 1134669740
Provider Name (Legal Business Name): EMANUELE HEARING HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2017
Last Update Date: 03/01/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6783 VETERANS PKWY 300 BLDG 4
COLUMBUS GA
31909-3254
US

IV. Provider business mailing address

3949 MULLENHURST DR
PALM HARBOR FL
34685-3666
US

V. Phone/Fax

Practice location:
  • Phone: 706-576-9888
  • Fax:
Mailing address:
  • Phone: 727-424-3121
  • Fax: 727-934-9197

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number
License Number State

VIII. Authorized Official

Name: MR. JOHN EMANUELE
Title or Position: AMBR/PRESIDENT
Credential:
Phone: 727-424-3121