MEDICARE: SOUTH ATLANTIC HEARING LLC

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

General Provider Information

NPI Number	:	1073885372
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTH ATLANTIC HEARING LLC

Provider Business Mailing Address
First Line	:	131 ENTERPRISE RD
Second Line	:
City	:	JOHNSTOWN
State	:	NY
Zip	:	12095-3326
Country	:	US
Telephone Number	:	518-736-2284
Fax Number	:	518-620-5727

Provider Business Practice Location Address
First Line	:	5100 BUCKEYSTOWN PIKE
Second Line	:
City	:	FREDERICK
State	:	MD
Zip	:	21704-8336
Country	:	US
Telephone Number	:	301-696-9757
Fax Number	:	301-696-0879

Authorized Official
Title or Position	:	MANAGING PARTNER
Name	:	DAN WHIPKEY
Credential	:
Telephone Number	:	518-736-2284

Provider Enumeration Date	:	02/01/2012
Last Update Date	:	02/20/2023

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Directions to “SOUTH ATLANTIC HEARING LLC ” Practice Location

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