MEDICARE: PREMIER HEARING

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	261QH0700X	Hearing and Speech Clinic/Center

General Provider Information

NPI Number	:	1174206585
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PREMIER HEARING

Provider Business Mailing Address
First Line	:	16 PUBLIC SQ W
Second Line	:
City	:	JACKSONVILLE
State	:	AL
Zip	:	36265-2509
Country	:	US
Telephone Number	:	256-644-5114
Fax Number	:

Provider Business Practice Location Address
First Line	:	16 PUBLIC SQ W
Second Line	:
City	:	JACKSONVILLE
State	:	AL
Zip	:	36265-2509
Country	:	US
Telephone Number	:	256-644-5114
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	REBECCA MCMAHAN
Credential	:
Telephone Number	:	256-690-8081

Provider Enumeration Date	:	08/11/2023
Last Update Date	:	08/11/2023

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