Healthcare Provider Details

I. General information

NPI: 1760669725
Provider Name (Legal Business Name): HEARING CENTER OF SOUTHAMPTON, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2008
Last Update Date: 03/21/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

545 STREET RD
SOUTHAMPTON PA
18966-3786
US

IV. Provider business mailing address

545 STREET RD
SOUTHAMPTON PA
18966-3786
US

V. Phone/Fax

Practice location:
  • Phone: 215-953-0513
  • Fax: 215-953-0516
Mailing address:
  • Phone: 215-953-0513
  • Fax: 215-953-0516

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License NumberSC003337L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License NumberAT000591L
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberSC003337L
License Number StatePA

VIII. Authorized Official

Name: DR. CATHERINE HENRY
Title or Position: PODIATRIST; AUDIOLOGIST
Credential: DPM.; MCAA
Phone: 215-953-0513