Healthcare Provider Details

I. General information

NPI: 1386169019
Provider Name (Legal Business Name): GN HEARING CARE CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2017
Last Update Date: 08/03/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

319 S RALEIGH ST
MARTINSBURG WV
25401-2638
US

IV. Provider business mailing address

2601 PATRIOT BLVD
GLENVIEW IL
60026-8023
US

V. Phone/Fax

Practice location:
  • Phone: 304-267-4181
  • Fax: 304-267-4497
Mailing address:
  • Phone: 847-832-3695
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. JOHN PATRICK MCELVOGUE
Title or Position: RETAIL STAFF ACCOUNTANT
Credential:
Phone: 847-832-3695