Healthcare Provider Details

I. General information

NPI: 1902030224
Provider Name (Legal Business Name): NORTHLAND HEARING CENTERS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2009
Last Update Date: 05/14/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7615 CASS ST
OMAHA NE
68114-3623
US

IV. Provider business mailing address

10570 SE WASHINGTON ST STE 202
PORTLAND OR
97216-2846
US

V. Phone/Fax

Practice location:
  • Phone: 402-991-4327
  • Fax:
Mailing address:
  • Phone: 503-257-6800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number226
License Number StateNE

VIII. Authorized Official

Name: MR. JEFF LONGTAIN
Title or Position: PRESIDENT
Credential:
Phone: 503-257-6800