Healthcare Provider Details
I. General information
NPI: 1851343958
Provider Name (Legal Business Name): NORTHLAND HEARING CENTERS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/17/2006
Last Update Date: 05/09/2024
Certification Date: 05/09/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1103 W MAIN ST
MARION IL
62959-1843
US
IV. Provider business mailing address
6700 WASHINGTON AVE S
EDEN PRAIRIE MN
55344-3405
US
V. Phone/Fax
- Phone: 618-997-6975
- Fax: 618-998-9735
- Phone: 612-351-1529
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QH0700X |
| Taxonomy | Hearing and Speech Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
HEATHER
REMER
Title or Position: INSURANCE MANAGER
Credential:
Phone: 952-300-6218