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General NPI Number Information
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NPI Number | 1841651866
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Entity Type | Organization
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Legal Business Name | SAM'S HEARING AID CENTER #6332
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Dates
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Enumeration Date | 03/18/2016
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Last Update Date | 03/18/2016
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Provider Practice Location Address
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Address Line | 1000 FRANKLIN MILLS CIR
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City | PHILADELPHIA
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State | PA
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Zip | 19154-3115
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Country | US
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Telephone | 215-613-1201
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Fax |
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Provider Business Mailing Address
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Address Line | 1000 FRANKLIN MILLS CIR
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City | PHILADELPHIA
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State | PA
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Zip | 19154-3115
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Country | US
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Telephone | 215-613-1201
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Fax |
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Authorized Official
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Title or Position | HEARING INSTRUMENT SPECIALIST
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Name | ROBIN MICHAEL FARYNA
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Credential | BC-HIS
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Telephone | 215-613-1201
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332S00000X
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Taxonomy Name | Hearing Aid Equipment
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License Number | F03577
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License Number State | PA
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