1386086098 NPI number — CHESTER HEIGHTS HEARING AID CENTER, LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386086098 NPI number — CHESTER HEIGHTS HEARING AID CENTER, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CHESTER HEIGHTS HEARING AID CENTER, 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:
Provider Other Organization Name Type Code:
6
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:
1386086098
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/23/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
327 W. BALTIMORE PIKE
Provider Second Line Business Mailing Address:
LOCUST HILL PROFESSIONAL CENTER , FLOOR # 1
Provider Business Mailing Address City Name:
CHESTER HEIGHTS
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19063-5625
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
484-574-8777
Provider Business Mailing Address Fax Number:
484-574-8828

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
327 W. BALTIMORE PIKE
Provider Second Line Business Practice Location Address:
LOCUST HILL PROFESSIONAL CENTER , FLOOR # 1
Provider Business Practice Location Address City Name:
CHESTER HEIGHTS
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19063-5625
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
484-574-8777
Provider Business Practice Location Address Fax Number:
484-574-8828
Provider Enumeration Date:
07/23/2013

Additional Information

Authorized Official

Authorized Official Last Name:
CLAFFEY
Authorized Official First Name:
RICHARD
Authorized Official Middle Name:
P.
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
484-574-8777

Provider Taxonomy Codes

  • Taxonomy code: 237700000X , with the licence number:  FO2398 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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