Healthcare Provider Details

I. General information

NPI: 1184775439
Provider Name (Legal Business Name): INDIANA HEARING AID AT NOBLESVILLE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/15/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 N 10TH ST
NOBLESVILLE IN
46060-2202
US

IV. Provider business mailing address

160 N 10TH ST
NOBLESVILLE IN
46060-2202
US

V. Phone/Fax

Practice location:
  • Phone: 317-773-9143
  • Fax:
Mailing address:
  • Phone: 317-773-9143
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number23001002A
License Number StateIN

VIII. Authorized Official

Name: MRS. MARCI DAVIS
Title or Position: TREASURER
Credential:
Phone: 317-773-9143