Healthcare Provider Details

I. General information

NPI: 1306337365
Provider Name (Legal Business Name): GN HEARING CARE CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2018
Last Update Date: 05/25/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

408 MAIN ST
COLUMBUS MS
39701-4548
US

IV. Provider business mailing address

2601 PATRIOT BLVD
GLENVIEW IL
60026-8023
US

V. Phone/Fax

Practice location:
  • Phone: 662-328-8002
  • Fax:
Mailing address:
  • Phone: 847-832-3695
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JOHN PATRICK MCELVOGUE
Title or Position: RETAIL STAFF ACCOUNTANT
Credential:
Phone: 847-832-3695