MEDICARE: NORTHLAND HEARING CENTERS, INC

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	237600000X	Audiologist-Hearing Aid Fitter
2	261QH0700X	Hearing and Speech Clinic/Center

General Provider Information

NPI Number	:	1750712238
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTHLAND HEARING CENTERS, INC

Provider Business Mailing Address
First Line	:	8800 SE SUNNYSIDE RD STE 300N
Second Line	:
City	:	CLACKAMAS
State	:	OR
Zip	:	97015-5703
Country	:	US
Telephone Number	:	281-286-2999
Fax Number	:	512-607-4893

Provider Business Practice Location Address
First Line	:	8283 N PINE ISLAND RD
Second Line	:
City	:	TAMARAC
State	:	FL
Zip	:	33321-1541
Country	:	US
Telephone Number	:	954-721-0003
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR OF FINANCE
Name	:	JENNIFER MELES
Credential	:
Telephone Number	:	952-947-4889

Provider Enumeration Date	:	12/09/2013
Last Update Date	:	05/02/2018

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