1265807291 NPI number — GHB HEARING, LLC

Table of content: (NPI 1265807291)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265807291 NPI number — GHB HEARING, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GHB HEARING, LLC
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:
BELTONE
Provider Other Organization Name Type Code:
3
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:
1265807291
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/02/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 71976
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DURHAM
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27722-1976
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
919-245-3800
Provider Business Mailing Address Fax Number:
919-245-3511

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
197 OLD FARM RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ROANOKE RAPIDS
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27870-3343
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
252-443-9955
Provider Business Practice Location Address Fax Number:
252-210-3466
Provider Enumeration Date:
12/02/2015

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
HATFIELD-BERRANG
Authorized Official First Name:
GERALD
Authorized Official Middle Name:
WILLIAM
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
919-245-3800

Provider Taxonomy Codes

  • Taxonomy code: 237700000X , with the licence number:  878 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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