MEDICARE: NORTHLAND HEARING CENTERS, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332S00000X	Hearing Aid Equipment
2	261QH0700X	Hearing and Speech Clinic/Center

General Provider Information

NPI Number	:	1053763086
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTHLAND HEARING CENTERS, INC.

Provider Business Mailing Address
First Line	:	6700 WASHINGTON AVE S
Second Line	:
City	:	EDEN PRAIRIE
State	:	MN
Zip	:	55344-3405
Country	:	US
Telephone Number	:	800-328-8602
Fax Number	:

Provider Business Practice Location Address
First Line	:	21820 KINGSLAND BLVD STE 104
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77450-2507
Country	:	US
Telephone Number	:	281-769-5295
Fax Number	:	281-579-7843

Authorized Official
Title or Position	:	INSURANCE MANAGER
Name	:	HEATHER REMER
Credential	:
Telephone Number	:	952-300-6218

Provider Enumeration Date	:	07/01/2016
Last Update Date	:	05/08/2024

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