Healthcare Provider Details
I. General information
NPI: 1366682627
Provider Name (Legal Business Name): NORTHLAND HEARING CENTERS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/26/2009
Last Update Date: 11/13/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1930 9TH AVE STE 180
HELENA MT
59601-4759
US
IV. Provider business mailing address
6700 WASHINGTON AVE S
EDEN PRAIRIE MN
55344-3405
US
V. Phone/Fax
- Phone: 406-443-2275
- Fax: 406-443-2278
- Phone: 800-328-8602
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332S00000X |
| Taxonomy | Hearing Aid Equipment |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QH0700X |
| Taxonomy | Hearing and Speech Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
REGINA
KRISTINE
TOENSING
Title or Position: CREDENTIALING MANAGER
Credential:
Phone: 952-915-6255