Provider Demographics
NPI:1902443161
Name:NORTHERN INDIANA HEARING CENTER
Entity Type:Organization
Organization Name:NORTHERN INDIANA HEARING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:P
Authorized Official - Last Name:NORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:574-383-5595
Mailing Address - Street 1:2406 MISHAWAKA AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46615-2100
Mailing Address - Country:US
Mailing Address - Phone:574-383-5595
Mailing Address - Fax:574-520-1505
Practice Address - Street 1:2406 MISHAWAKA AVE
Practice Address - Street 2:
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46615-2100
Practice Address - Country:US
Practice Address - Phone:574-383-5595
Practice Address - Fax:574-520-1505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-06
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment