Healthcare Provider Details

I. General information

NPI: 1265703003
Provider Name (Legal Business Name): HEARING AID SERVICES OF ATLANTA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2012
Last Update Date: 01/25/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1240 HIGHWAY 54 W STE. 604
FAYETTEVILLE GA
30214-4557
US

IV. Provider business mailing address

1240 HIGHWAY 54 W SUITE 604
FAYETTEVILLE GA
30214-4557
US

V. Phone/Fax

Practice location:
  • Phone: 770-461-7002
  • Fax: 770-461-7070
Mailing address:
  • Phone: 770-461-7002
  • Fax: 770-461-7070

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: MRS. BARBARA J. STOCK
Title or Position: HEARING INSTRUMENT SPECIALIST
Credential: HIS
Phone: 770-461-7002