Provider Demographics
NPI:1194903419
Name:SOUND CARE AUDIOLOGY, INC.
Entity type:Organization
Organization Name:SOUND CARE AUDIOLOGY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:SHERYL
Authorized Official - Last Name:BOATZ
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:812-299-8178
Mailing Address - Street 1:4531 S 7TH ST
Mailing Address - Street 2:
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47802-4503
Mailing Address - Country:US
Mailing Address - Phone:812-234-3277
Mailing Address - Fax:812-234-3507
Practice Address - Street 1:4531 S 7TH ST
Practice Address - Street 2:
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47802-4503
Practice Address - Country:US
Practice Address - Phone:812-234-3277
Practice Address - Fax:812-234-3507
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-08
Last Update Date:2015-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200888160AMedicaid