Healthcare Provider Details

I. General information

NPI: 1528232196
Provider Name (Legal Business Name): RICK THOMAS BROOKE NBS,HIS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2008
Last Update Date: 04/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

430 WILLIAM HILTON PKWY SUITE 208
HILTON HEAD ISLAND SC
29926-2424
US

IV. Provider business mailing address

430 WILLIAM HILTON PKWY SUITE 208
HILTON HEAD ISLAND SC
29926-2424
US

V. Phone/Fax

Practice location:
  • Phone: 843-986-0003
  • Fax:
Mailing address:
  • Phone: 843-986-0003
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number444
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: