Healthcare Provider Details

I. General information

NPI: 1467082669
Provider Name (Legal Business Name): BREVARD HEARING CENTER OF NORTH CAROLINA PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2020
Last Update Date: 01/16/2020
Certification Date: 01/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

424 S CALDWELL ST
BREVARD NC
28712-3904
US

IV. Provider business mailing address

236 SPICEWOOD LN
HENDERSONVILLE NC
28791-1343
US

V. Phone/Fax

Practice location:
  • Phone: 828-966-4327
  • Fax:
Mailing address:
  • Phone: 859-753-8812
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State

VIII. Authorized Official

Name: CASEY ELAINE PENCEK
Title or Position: OWNER/PROVIDER
Credential: AU.D.
Phone: 828-490-8776