MEDICARE: ADVANCED AUDIOLOGY INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	231H00000X	Audiologist	23002221A	IN

General Provider Information

NPI Number	:	1447491378
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED AUDIOLOGY INC.

Provider Business Mailing Address
First Line	:	1020 W JEFFERSON ST
Second Line	:
City	:	FRANKLIN
State	:	IN
Zip	:	46131-2124
Country	:	US
Telephone Number	:	317-736-0080
Fax Number	:	317-736-9301

Provider Business Practice Location Address
First Line	:	1020 W JEFFERSON ST
Second Line	:
City	:	FRANKLIN
State	:	IN
Zip	:	46131-2124
Country	:	US
Telephone Number	:	317-736-0080
Fax Number	:	317-736-9301

Authorized Official
Title or Position	:	PRESIDENT/OWNER
Name	:	DR. CARRIE A HILL-VILLANUEVA
Credential	:	AU.D.
Telephone Number	:	317-736-0080

Provider Enumeration Date	:	03/24/2009
Last Update Date	:	08/25/2015

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