Healthcare Provider Details

I. General information

NPI: 1396931259
Provider Name (Legal Business Name): DR. ENGELBERTH'S HEARING CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2007
Last Update Date: 02/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1610 E CENTER ST
WARSAW IN
46580-3651
US

IV. Provider business mailing address

1610 E CENTER ST
WARSAW IN
46580-3651
US

V. Phone/Fax

Practice location:
  • Phone: 574-269-5828
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number23001826A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number23001826A
License Number StateIN

VIII. Authorized Official

Name: SANDRA KAY ENGELBERTH
Title or Position: OWNER
Credential:
Phone: 574-269-5828