Healthcare Provider Details
I. General information
NPI: 1700235231
Provider Name (Legal Business Name): NORTHLAND HEARING CENTERS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/06/2016
Last Update Date: 05/08/2024
Certification Date: 05/08/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2400 VETERANS BLVD STE 13
DEL RIO TX
78840-3136
US
IV. Provider business mailing address
6700 WASHINGTON AVE S
EDEN PRAIRIE MN
55344-3405
US
V. Phone/Fax
- Phone: 830-775-9400
- Fax: 830-775-5511
- Phone: 800-328-8602
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332S00000X |
| Taxonomy | Hearing Aid Equipment |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QH0700X |
| Taxonomy | Hearing and Speech Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KATIE
ANN
KLEIN
Title or Position: MANAGER OF THIRD PARTY PROGRAMS
Credential:
Phone: 952-999-5529