=====================================================
General NPI Number Information
=====================================================
NPI Number | 1336468230
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | IOWA HEARING INSTRUMENTS LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/18/2010
-----------------------------------------------------
Last Update Date | 02/02/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1011 N JEFFERSON WAY STE 200
-----------------------------------------------------
City | INDIANOLA
-----------------------------------------------------
State | IA
-----------------------------------------------------
Zip | 50125-1499
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 515-961-6756
-----------------------------------------------------
Fax | 515-962-2017
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 131 ENTERPRISE RD
-----------------------------------------------------
City | JOHNSTOWN
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 12095-3326
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 401-353-4174
-----------------------------------------------------
Fax | 401-488-5774
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | HEARING INSTRUMENT SPECIALIST
-----------------------------------------------------
Name | CORY POPELKA
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 518-736-2284
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332S00000X
-----------------------------------------------------
Taxonomy Name | Hearing Aid Equipment
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------