Organization
SOUTHEASTERN HEARING, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TROY MAHAN H.A.S. NBC-HIS (OWNER/PRESIDENT)
(904) 247-4327
Entity
Organization
Contact information
Practice address
4006 3RD ST S, JACKSONVILLE BEACH, FL 32250-5848
(904) 247-4327
Mailing address
4006 3RD ST S, JACKSONVILLE BEACH, FL 32250-5848
Taxonomy
Speciality
Code
Description
License number
State
332S00000X
Hearing Aid Equipment
Primary
AS2210
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
J0655
BCBS
FL
Enumeration date
02/22/2017
Last updated
02/22/2017
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