Healthcare Provider Details

I. General information

NPI: 1285708867
Provider Name (Legal Business Name): ROSS HEARING CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/17/2006
Last Update Date: 05/01/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1609 E 80TH AVE
MERRILLVILLE IN
46410-5737
US

IV. Provider business mailing address

1609 E 80TH AVE
MERRILLVILLE IN
46410-5737
US

V. Phone/Fax

Practice location:
  • Phone: 219-738-2730
  • Fax: 219-738-2743
Mailing address:
  • Phone: 219-738-2730
  • Fax: 219-738-2743

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number23001159
License Number StateIN

VIII. Authorized Official

Name: MS. DIANE VOELKER
Title or Position: GENERAL MANAGER
Credential: M.S., CCC-A
Phone: 219-738-2730