Provider Demographics
NPI:1215436316
Name:HOMETOWN HEARING & AUDIOLOGY, LLC
Entity type:Organization
Organization Name:HOMETOWN HEARING & AUDIOLOGY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BRANDY
Authorized Official - Middle Name:K
Authorized Official - Last Name:WEAVER
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:260-306-3444
Mailing Address - Street 1:225 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NORTH MANCHESTER
Mailing Address - State:IN
Mailing Address - Zip Code:46962-1824
Mailing Address - Country:US
Mailing Address - Phone:260-306-3444
Mailing Address - Fax:260-306-3777
Practice Address - Street 1:225 E MAIN ST
Practice Address - Street 2:
Practice Address - City:NORTH MANCHESTER
Practice Address - State:IN
Practice Address - Zip Code:46962-1824
Practice Address - Country:US
Practice Address - Phone:260-306-3444
Practice Address - Fax:260-306-3777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-05
Last Update Date:2018-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN23002531A231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty