Healthcare Provider Details

I. General information

NPI: 1558871012
Provider Name (Legal Business Name): AUDIBEL OF MUNCIE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2017
Last Update Date: 10/10/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

908 W MCGALLIARD RD STE 2
MUNCIE IN
47303-1702
US

IV. Provider business mailing address

908 W MCGALLIARD RD STE 2
MUNCIE IN
47303-1702
US

V. Phone/Fax

Practice location:
  • Phone: 765-287-1245
  • Fax: 765-288-4574
Mailing address:
  • Phone: 765-287-1245
  • Fax: 765-288-4574

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number23002476A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number17001152A
License Number StateIN

VIII. Authorized Official

Name: JEFF R ROWE
Title or Position: OWNER
Credential: HAD
Phone: 765-287-1245