Organization
SOUTHERN HOME HEARING LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES REGINAL HARRISON BC-HIS (CEO/PROVIDER)
(912) 436-0330
Entity
Organization
Contact information
Practice address
201 GENTILLY RD, STATESBORO, GA 30458-5131
(912) 436-0330
Mailing address
201 GENTILLY RD, STATESBORO, GA 30458-5131
(912) 436-0330
Taxonomy
Speciality
Code
Description
License number
State
332S00000X
Hearing Aid Equipment
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HADS001003
HEARING AID DESPENSOR
GA
Enumeration date
07/13/2020
Last updated
09/06/2023
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