MEDICARE: HEARING LIFESTYLES, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	231H00000X	Audiologist	2194	NC

General Provider Information

NPI Number	:	1538431887
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEARING LIFESTYLES, LLC

Provider Business Mailing Address
First Line	:	549 E COUNTY LINE RD
Second Line	:	SUITE F
City	:	GREENWOOD
State	:	IN
Zip	:	46143-1067
Country	:	US
Telephone Number	:	317-300-1240
Fax Number	:	317-759-2558

Provider Business Practice Location Address
First Line	:	464 JAKE ALEXANDER BLVD W
Second Line	:
City	:	SALISBURY
State	:	NC
Zip	:	28147-1365
Country	:	US
Telephone Number	:	704-633-0023
Fax Number	:	704-705-2363

Authorized Official
Title or Position	:	SENIOR MANAGER
Name	:	MR. PAUL JOHN ROSIEK
Credential	:
Telephone Number	:	317-379-3333

Provider Enumeration Date	:	02/02/2012
Last Update Date	:	02/02/2012

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