Healthcare Provider Details

I. General information

NPI: 1033693098
Provider Name (Legal Business Name): WILSONS HEARING AID CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2018
Last Update Date: 09/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3716 N WHEELING AVE
MUNCIE IN
47304-1766
US

IV. Provider business mailing address

3716 N WHEELING AVE
MUNCIE IN
47304-1766
US

V. Phone/Fax

Practice location:
  • Phone: 765-747-4131
  • Fax:
Mailing address:
  • Phone: 765-747-4131
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: STUART M ROBINSON
Title or Position: OWNER/MEMBER
Credential:
Phone: 765-747-4131