Healthcare Provider Details

I. General information

NPI: 1376948091
Provider Name (Legal Business Name): AMBIT HEARING AID CENTERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2014
Last Update Date: 10/23/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1636 OAKBROOK DR SUITE B
GAINESVILLE GA
30507-8492
US

IV. Provider business mailing address

1636 OAKBROOK DR SUITE B
GAINESVILLE GA
30507-8492
US

V. Phone/Fax

Practice location:
  • Phone: 770-534-4150
  • Fax:
Mailing address:
  • Phone: 770-534-4150
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberHADE034823
License Number StateGA

VIII. Authorized Official

Name: MR. TIMOTHY O'BRYAN PEPPER
Title or Position: PRESIDENT
Credential: H.I.S.
Phone: 770-534-4150