Healthcare Provider Details

I. General information

NPI: 1114256922
Provider Name (Legal Business Name): PAMELA THOMPSON HEARING AID SPECIALI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2009
Last Update Date: 10/13/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1118 E MAIN ST
SALISBURY MD
21804-4460
US

IV. Provider business mailing address

1118 E MAIN ST
SALISBURY MD
21804-4460
US

V. Phone/Fax

Practice location:
  • Phone: 410-219-5088
  • Fax:
Mailing address:
  • Phone: 410-219-5088
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number2102002483
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: