Provider Demographics
NPI:1285956839
Name:HEARING AID OUTLET
Entity type:Organization
Organization Name:HEARING AID OUTLET
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DANNY
Authorized Official - Middle Name:L
Authorized Official - Last Name:AHRENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:765-348-3558
Mailing Address - Street 1:0660 E 200 S
Mailing Address - Street 2:
Mailing Address - City:HARTFORD CITY
Mailing Address - State:IN
Mailing Address - Zip Code:47348-9733
Mailing Address - Country:US
Mailing Address - Phone:765-348-3558
Mailing Address - Fax:765-348-4381
Practice Address - Street 1:1608 N CHERRY ST
Practice Address - Street 2:
Practice Address - City:HARTFORD CITY
Practice Address - State:IN
Practice Address - Zip Code:47348-1356
Practice Address - Country:US
Practice Address - Phone:765-348-3558
Practice Address - Fax:765-348-4381
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-24
Last Update Date:2010-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN17001114A332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment