Healthcare Provider Details

I. General information

NPI: 1942636485
Provider Name (Legal Business Name): HARBORSIDE HEARING CARE CENTERS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2013
Last Update Date: 09/16/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1421 ORLEANS ROAD
HARWICH MA
02645
US

IV. Provider business mailing address

1421 ORLEANS ROAD
HARWICH MA
02645
US

V. Phone/Fax

Practice location:
  • Phone: 508-432-1222
  • Fax: 508-430-8686
Mailing address:
  • Phone: 508-432-1222
  • Fax: 508-430-8686

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberHIS#49
License Number StateMA

VIII. Authorized Official

Name: DARLENE PEKENIA
Title or Position: PRESIDENT
Credential: H.I.S.
Phone: 508-524-4783