MEDICARE: AMBER COLLINGTON HIS

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	237700000X	Hearing Instrument Specialist	HAS-0749	SC

General Provider Information

NPI Number	:	1326880261
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMBER COLLINGTON HIS

Provider Business Mailing Address
First Line	:	3702 SEA MOUNTAIN HWY STE B
Second Line	:
City	:	LITTLE RIVER
State	:	SC
Zip	:	29566-7860
Country	:	US
Telephone Number	:	843-734-0540
Fax Number	:	843-734-0542

Provider Business Practice Location Address
First Line	:	3702 SEA MOUNTAIN HWY STE B
Second Line	:
City	:	LITTLE RIVER
State	:	SC
Zip	:	29566-7860
Country	:	US
Telephone Number	:	843-734-0540
Fax Number	:	843-734-0542

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/11/2024
Last Update Date	:	06/11/2024

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