MEDICARE: AMBIT HEARING AID CENTERS

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	HADE034823	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	HADE034823	OTHER	GA	HEARING AID DISPENSER

General Provider Information

NPI Number	:	1376948091
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMBIT HEARING AID CENTERS

Provider Business Mailing Address
First Line	:	1636 OAKBROOK DR
Second Line	:	SUITE B
City	:	GAINESVILLE
State	:	GA
Zip	:	30507-8492
Country	:	US
Telephone Number	:	770-534-4150
Fax Number	:

Provider Business Practice Location Address
First Line	:	1636 OAKBROOK DR
Second Line	:	SUITE B
City	:	GAINESVILLE
State	:	GA
Zip	:	30507-8492
Country	:	US
Telephone Number	:	770-534-4150
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. TIMOTHY O'BRYAN PEPPER
Credential	:	H.I.S.
Telephone Number	:	770-534-4150

Provider Enumeration Date	:	10/23/2014
Last Update Date	:	10/23/2014

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Directions to “AMBIT HEARING AID CENTERS ” Practice Location

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