Healthcare Provider Details

I. General information

NPI: 1538334040
Provider Name (Legal Business Name): THE EDITH & HENRY HEUSER HEARING INSTITUTE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2008
Last Update Date: 04/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

117 E KENTUCKY ST
LOUISVILLE KY
40203-2793
US

IV. Provider business mailing address

115 E KENTUCKY ST
LOUISVILLE KY
40203-2793
US

V. Phone/Fax

Practice location:
  • Phone: 502-584-3573
  • Fax: 502-583-6364
Mailing address:
  • Phone: 502-515-3320
  • Fax: 502-515-3325

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number
License Number State

VIII. Authorized Official

Name: MONA K MCCUBBIN
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 502-515-3320