=====================================================
General NPI Number Information
=====================================================
NPI Number | 1730627316
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | INDIANA HEARING LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/03/2017
-----------------------------------------------------
Last Update Date | 11/03/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 10059 E WASHINGTON ST
-----------------------------------------------------
City | INDIANAPOLIS
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 46229-2623
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 317-897-0615
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 131 ENTERPRISE RD
-----------------------------------------------------
City | JOHNSTOWN
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 12095-3326
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 518-736-2284
-----------------------------------------------------
Fax | 518-620-5727
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | HEARING INSTRUMENT SPECIALIST
-----------------------------------------------------
Name | AUSTIN FIDLER
-----------------------------------------------------
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 |
-----------------------------------------------------