Healthcare Provider Details
I. General information
NPI: 1992271282
Provider Name (Legal Business Name): ME PIVOT HOLDINGS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/15/2018
Last Update Date: 09/02/2021
Certification Date: 09/02/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1533 FORDING ISLAND RD STE 318
HILTON HEAD ISLAND SC
29926-1122
US
IV. Provider business mailing address
150 S 5TH ST STE 2300
MINNEAPOLIS MN
55402-4223
US
V. Phone/Fax
- Phone: 843-836-2693
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 237700000X |
| Taxonomy | Hearing Instrument Specialist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KEN
HALL
Title or Position: PRESIDENT
Credential:
Phone: 763-268-4000