Healthcare Provider Details

I. General information

NPI: 1871056952
Provider Name (Legal Business Name): ANDRES RINCON HEARING INSTRUMENT S
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/07/2019
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

341 SOUTHLAND DRIVE #110
LEXINGTON KY
40503
US

IV. Provider business mailing address

3704 RIDGE VIEW WAY
LEXINGTON KY
40509
US

V. Phone/Fax

Practice location:
  • Phone: 859-479-3808
  • Fax: 859-359-7999
Mailing address:
  • Phone: 859-479-3808
  • Fax: 859-359-7999

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number242066
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number242066
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number242066
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: