Healthcare Provider Details

I. General information

NPI: 1134265143
Provider Name (Legal Business Name): SUPERIOR HEARING COMPANY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 ELIDA RD SEARS HEARING - LIMA MALL
LIMA OH
45805-1299
US

IV. Provider business mailing address

PO BOX 623
HUNTERTOWN IN
46748-0623
US

V. Phone/Fax

Practice location:
  • Phone: 419-331-5965
  • Fax: 419-331-8646
Mailing address:
  • Phone: 260-483-2700
  • Fax: 260-484-1620

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number02573
License Number StateOH

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier22000000258609
Identifier TypeOTHER
Identifier StateIN
Identifier IssuerANTHEM BC-BS

VIII. Authorized Official

Name: JO ANN ROBINSON
Title or Position: PRESIDENT
Credential:
Phone: 260-483-2700