Healthcare Provider Details

I. General information

NPI: 1164066478
Provider Name (Legal Business Name): ALPACA AUDIOLOGY IN & VA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/30/2019
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4720 E STATE BLVD
FORT WAYNE IN
46815-6923
US

IV. Provider business mailing address

35 WATERVIEW BLVD STE 305
PARSIPPANY NJ
07054-7604
US

V. Phone/Fax

Practice location:
  • Phone: 260-471-5693
  • Fax:
Mailing address:
  • Phone: 973-588-7266
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State

VIII. Authorized Official

Name: VICKI COLE
Title or Position: CFO
Credential:
Phone: 973-588-7266