Provider Demographics
NPI:1023213345
Name:BEDFORD HEARING AID SPECIALISTS, INC.
Entity Type:Organization
Organization Name:BEDFORD HEARING AID SPECIALISTS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:LIBBY
Authorized Official - Middle Name:
Authorized Official - Last Name:TIREY
Authorized Official - Suffix:
Authorized Official - Credentials:BC-HIS
Authorized Official - Phone:812-279-8232
Mailing Address - Street 1:2809 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:IN
Mailing Address - Zip Code:47421-5310
Mailing Address - Country:US
Mailing Address - Phone:812-279-8232
Mailing Address - Fax:812-279-5884
Practice Address - Street 1:2809 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:IN
Practice Address - Zip Code:47421-5310
Practice Address - Country:US
Practice Address - Phone:812-279-8232
Practice Address - Fax:812-279-5884
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN17000848A261QH0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000201140OtherANTHEM