=====================================================
General NPI Number Information
=====================================================
NPI Number | 1013887744
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PENPOT VENTURES CORP
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/07/2025
-----------------------------------------------------
Last Update Date | 11/07/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5052 OLD BUNCOMBE RD STE H
-----------------------------------------------------
City | GREENVILLE
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29617-8260
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 864-561-5687
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 406 SILVER CREEK RD
-----------------------------------------------------
City | GREER
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29650-3418
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 864-561-5687
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MR. ANDREAS W PENNINGER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 864-561-5687
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 237700000X
-----------------------------------------------------
Taxonomy Name | Hearing Instrument Specialist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------