MEDICARE: TROY GREENWALD ENTERPRISES 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	237700000X	Hearing Instrument Specialist	751	TN

General Provider Information

NPI Number	:	1982002069
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TROY GREENWALD ENTERPRISES LLC

Provider Business Mailing Address
First Line	:	2231 E MILLBROOK RD
Second Line	:	SUITE 121
City	:	RALEIGH
State	:	NC
Zip	:	27604-1746
Country	:	US
Telephone Number	:	919-954-9996
Fax Number	:	919-954-7511

Provider Business Practice Location Address
First Line	:	2231 E MILLBROOK RD
Second Line	:	SUITE 121
City	:	RALEIGH
State	:	NC
Zip	:	27604-1746
Country	:	US
Telephone Number	:	919-954-9996
Fax Number	:	919-954-7511

Authorized Official
Title or Position	:	PRESIDENT
Name	:	TROY GREENWALD
Credential	:	HIS
Telephone Number	:	919-956-9996

Provider Enumeration Date	:	12/05/2014
Last Update Date	:	12/05/2014

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