| Organization Name: | NORTHEAST GEORGIA HEARING AID CENTER LLC |
| NPI Number: | 1972951317 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | FARRAH DANIELLE ESHAKSHUKI (OWNER) |
| Mailing Address: | 165 Towne Center Pkwy Hoschton |
| State: | GA US |
| Postal Code: | 305482211 |
| Phone Number: | 7066840731 |
| Fax Number: | |
| NPI Enumeration Date: | 05/26/2016 |
| NPI Last Update Date: | 05/26/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332S00000X |
| License Number: | 830 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Hearing Aid Equipment |
| Taxonomy Specialization: | |
| Taxonomy Definition: | The manufacture and/or sale of electronic hearing aids, their component parts, and related products and services on a national basis. |