1023116795 NPI number — THE HEARING CLINIC

Table of content: (NPI 1023116795)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1023116795 NPI number — THE HEARING CLINIC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE HEARING CLINIC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1023116795
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/30/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 886
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BLACKSBURG
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
24063-0886
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
540-953-2916
Provider Business Mailing Address Fax Number:
540-951-0302

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
820 UNIVERSITY CITY BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BLACKSBURG
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
24060-2708
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
540-552-1904
Provider Business Practice Location Address Fax Number:
540-951-0302
Provider Enumeration Date:
09/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MANGELS
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
F
Authorized Official Title or Position:
BILLING MANAGER
Authorized Official Telephone Number:
540-953-2916

Provider Taxonomy Codes

  • Taxonomy code: 231H00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: C09445 . This is a "MEDICARE GROUP NUMBER" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com