Healthcare Provider Details

I. General information

NPI: 1730130741
Provider Name (Legal Business Name): FORT WAYNE HEARING CENTER & AUDIOLOGY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9131 LIMA RD
FORT WAYNE IN
46818-1803
US

IV. Provider business mailing address

9131 LIMA RD
FORT WAYNE IN
46818-1803
US

V. Phone/Fax

Practice location:
  • Phone: 260-489-2693
  • Fax: 260-489-1495
Mailing address:
  • Phone: 260-489-2693
  • Fax: 260-489-1495

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number23001870A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code231HA2400X
TaxonomyAssistive Technology Practitioner Audiologist
License Number23001870A
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code231HA2500X
TaxonomyAssistive Technology Supplier Audiologist
License Number23001870A
License Number StateIN
# 4
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number23001870A
License Number StateIN

VIII. Authorized Official

Name: MRS. DEBORAH ELLEN FALSTER
Title or Position: AUDIOLOGIST
Credential: M.A., CCC-A
Phone: 260-489-2693