Provider Demographics
NPI:1285708867
Name:ROSS HEARING CENTER, LLC
Entity type:Organization
Organization Name:ROSS HEARING CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:VOELKER
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-A
Authorized Official - Phone:219-738-2730
Mailing Address - Street 1:1609 E 80TH AVE
Mailing Address - Street 2:
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-5737
Mailing Address - Country:US
Mailing Address - Phone:219-738-2730
Mailing Address - Fax:219-738-2743
Practice Address - Street 1:1609 E 80TH AVE
Practice Address - Street 2:
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-5737
Practice Address - Country:US
Practice Address - Phone:219-738-2730
Practice Address - Fax:219-738-2743
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-17
Last Update Date:2013-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN23001159231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000182592OtherLOCAL BC BS
IN200310690AMedicaid
IN5087564OtherAETNA
IN640003968OtherRAIL ROAD MEDICARE
IN02340OtherHEAR USA
IN352112038OtherFISERV HEALTH
IN397546199OtherHEALTH AND WELFARE FUND
IN23001159OtherUNICARE
IN640003968OtherRAIL ROAD MEDICARE