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General NPI Number Information
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NPI Number | 1982987103
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Entity Type | Organization
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Legal Business Name | TRI-COUNTY AUDIOLOGY AND HEARING AID SERVICES INC
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Dates
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Enumeration Date | 09/23/2011
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Last Update Date | 02/04/2016
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Provider Practice Location Address
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Address Line | 3519 N LECANTO HWY
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City | BEVERLY HILLS
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State | FL
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Zip | 34465-3501
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Country | US
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Telephone | 352-746-1133
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Fax | 352-746-3474
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Provider Business Mailing Address
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Address Line | 3519 N LECANTO HWY
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City | BEVERLY HILLS
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State | FL
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Zip | 34465-3501
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Country | US
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Telephone | 352-746-1133
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Fax | 352-746-3474
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Authorized Official
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Title or Position | OWNER
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Name | MRS. REBEKAH PETTY
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Credential |
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Telephone | 352-746-1133
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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 | AS5043
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License Number State | FL
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