1437229028 NPI number — NORTH SHORE HEARING CENTER, LLC

Table of content: (NPI 1437229028)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437229028 NPI number — NORTH SHORE HEARING CENTER, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NORTH SHORE HEARING 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:
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:
1437229028
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
24 MORRILL PL
Provider Second Line Business Mailing Address:
2ND FLOOR
Provider Business Mailing Address City Name:
AMESBURY
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01913-3530
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
978-462-9628
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
24 MORRILL PL
Provider Second Line Business Practice Location Address:
2ND FLOOR
Provider Business Practice Location Address City Name:
AMESBURY
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01913-3530
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
978-462-9628
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/09/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ELIA
Authorized Official First Name:
CHARLES
Authorized Official Middle Name:
J
Authorized Official Title or Position:
OWNER AUDIOLOGIST
Authorized Official Telephone Number:
978-462-9628

Provider Taxonomy Codes

  • Taxonomy code: 231H00000X , with the licence number:  241W , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: VC6000170931 . This is a "MA. REHABILITATION" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 696651 . This is a "TUFT'S HEALTH PLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 0006000010056AD002 . This is a "COMMISSION FOR THE BLIND" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 9727469 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: AG0021 . This is a "BLUE CROSS AND BLUE SHEIL" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 017166 . This is a "NEIGHBORHOOD HEALTH PLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 36257 . This is a "HARVARD PILGRIM" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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