Healthcare Provider Details

I. General information

NPI: 1487064846
Provider Name (Legal Business Name): EAST COAST HEARING AND BALANCE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2014
Last Update Date: 12/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5000 US HIGHWAY 70 W SUITE 103
MOREHEAD CITY NC
28557-4531
US

IV. Provider business mailing address

5000 US HIGHWAY 70 W SUITE 103
MOREHEAD CITY NC
28557-4531
US

V. Phone/Fax

Practice location:
  • Phone: 252-773-0636
  • Fax:
Mailing address:
  • Phone: 919-302-7700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number10758
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code231HA2400X
TaxonomyAssistive Technology Practitioner Audiologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code231HA2500X
TaxonomyAssistive Technology Supplier Audiologist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number
License Number State

VIII. Authorized Official

Name: DR. GARY CHRISTOPHER GAINES II
Title or Position: OWNER/PRACTITIONER
Credential: AUD, PHD, CCC-A
Phone: 252-773-0636