Healthcare Provider Details

I. General information

NPI: 1528418266
Provider Name (Legal Business Name): NORTHLAND HEARING CENTERS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/14/2016
Last Update Date: 08/05/2020
Certification Date: 08/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3229 BROADWAY AVE STE F
NORTH BEND OR
97459-2203
US

IV. Provider business mailing address

26222 RANCH ROAD 12
DRIPPING SPRINGS TX
78620-4903
US

V. Phone/Fax

Practice location:
  • Phone: 541-756-8944
  • Fax: 541-808-0967
Mailing address:
  • Phone: 512-858-0300
  • Fax: 512-858-2714

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number
License Number State

VIII. Authorized Official

Name: MELONY WINCHESTER
Title or Position: SENIOR DIRECTOR OF RETAIL OPERATION
Credential:
Phone: 512-858-0300