1407231871 NPI number — ATLANTA HEARING ASSOCIATES OF TOCO HILLS, 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 1407231871 NPI number — ATLANTA HEARING ASSOCIATES OF TOCO HILLS, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ATLANTA HEARING ASSOCIATES OF TOCO HILLS, 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:
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:
1407231871
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/21/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
111 FIELDSTONE DR
Provider Second Line Business Mailing Address:
SUITE 106
Provider Business Mailing Address City Name:
MILLEDGEVILLE
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
31061-7106
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
478-452-0578
Provider Business Mailing Address Fax Number:
478-453-0967

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1991 N WILLIAMSBURG DR
Provider Second Line Business Practice Location Address:
SUITE A 100
Provider Business Practice Location Address City Name:
DECATUR
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30033-3500
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
404-500-1026
Provider Business Practice Location Address Fax Number:
404-883-2473
Provider Enumeration Date:
07/27/2015

Additional Information

Authorized Official

Authorized Official Last Name:
PRITCHETT
Authorized Official First Name:
JOY
Authorized Official Middle Name:
W
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
478-452-0578

Provider Taxonomy Codes

  • Taxonomy code: 231H00000X , with the licence number:  AUD000571 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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