1891221206 NPI number — TRI COUNTY HEARING AID, INC.

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 1891221206 NPI number — TRI COUNTY HEARING AID, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TRI COUNTY HEARING AID, INC.
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:
1891221206
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/04/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3519 N LECANTO HWY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BEVERLY HILLS
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34465-3501
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
352-746-1133
Provider Business Mailing Address Fax Number:
352-746-3474

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11115 SW 93RD COURT RD
Provider Second Line Business Practice Location Address:
SUITE 600
Provider Business Practice Location Address City Name:
OCALA
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34481-3103
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
352-270-2944
Provider Business Practice Location Address Fax Number:
352-228-4851
Provider Enumeration Date:
05/04/2017

Additional Information

Authorized Official

Authorized Official Last Name:
DITCHFIELD
Authorized Official First Name:
DAVID
Authorized Official Middle Name:
WAYNE
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
352-746-1234

Provider Taxonomy Codes

  • Taxonomy code: 237700000X , with the licence number:  AS 1650 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 000685400 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com