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General NPI Number Information
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NPI Number | 1992272553
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Entity Type | Organization
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Legal Business Name | INNOVATIVE HEARING SOLUTIONS OF INDIANA, INC
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Dates
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Enumeration Date | 10/31/2018
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Last Update Date | 06/13/2024
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Provider Practice Location Address
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Address Line | 750 PARK EAST BLVD STE 3
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City | LAFAYETTE
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State | IN
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Zip | 47905-0788
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Country | US
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Telephone | 765-771-7109
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Fax | 765-770-8668
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Provider Business Mailing Address
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Address Line | 480 W NAVAJO ST STE A
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City | WEST LAFAYETTE
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State | IN
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Zip | 47906-1940
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Country | US
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Telephone | 765-771-7109
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Fax | 765-770-8668
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Authorized Official
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Title or Position | ADMINISTRATIVE MANAGER
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Name | MRS. MOLLY ELIZABETH HERENDEEN
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Credential |
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Telephone | 765-771-7109
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332S00000X
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Taxonomy Name | Hearing Aid Equipment
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number |
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License Number State |
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