MEDICARE: EMANUELE HEARING HEALTHCARE 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	:	1134669740
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EMANUELE HEARING HEALTHCARE LLC

Provider Business Mailing Address
First Line	:	3949 MULLENHURST DR
Second Line	:
City	:	PALM HARBOR
State	:	FL
Zip	:	34685-3666
Country	:	US
Telephone Number	:	727-424-3121
Fax Number	:	727-934-9197

Provider Business Practice Location Address
First Line	:	6783 VETERANS PKWY
Second Line	:	300 BLDG 4
City	:	COLUMBUS
State	:	GA
Zip	:	31909-3254
Country	:	US
Telephone Number	:	706-576-9888
Fax Number	:

Authorized Official
Title or Position	:	AMBR/PRESIDENT
Name	:	MR. JOHN EMANUELE
Credential	:
Telephone Number	:	727-424-3121

Provider Enumeration Date	:	03/01/2017
Last Update Date	:	03/01/2017

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