Healthcare Provider Details

I. General information

NPI: 1417276023
Provider Name (Legal Business Name): OPTIMAL HEARING SYSTEMS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2010
Last Update Date: 07/28/2021
Certification Date: 07/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

905 N MAIN ST SUITE 102
SUMMERVILLE SC
29483-6600
US

IV. Provider business mailing address

PO BOX 6686
ATHENS GA
30604-6686
US

V. Phone/Fax

Practice location:
  • Phone: 843-821-5733
  • Fax:
Mailing address:
  • Phone: 706-860-9660
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number007204152
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number
License Number State

VIII. Authorized Official

Name: MR. GABRIEL PITT
Title or Position: VP
Credential:
Phone: 912-352-8530