Healthcare Provider Details

I. General information

NPI: 1235357344
Provider Name (Legal Business Name): TENNESSEE HEARING INSTRUMENT SPECIALISTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2007
Last Update Date: 04/20/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

124 GLANCY ST
GOODLETTSVILLE TN
37072-2306
US

IV. Provider business mailing address

124 GLANCY ST
GOODLETTSVILLE TN
37072-2306
US

V. Phone/Fax

Practice location:
  • Phone: 615-851-3901
  • Fax: 615-851-3903
Mailing address:
  • Phone: 615-851-3901
  • Fax: 615-851-3903

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number
License Number State

VIII. Authorized Official

Name: MR. WOLODYMYR R. STASIUK
Title or Position: CEO
Credential: ACA, BC-HIS
Phone: 615-851-3901