Provider Demographics
NPI:1033235387
Name:SEC ENTERPRISES, INC.
Entity Type:Organization
Organization Name:SEC ENTERPRISES, INC.
Other - Org Name:MIRACLE-EAR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:COKER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:219-738-1866
Mailing Address - Street 1:7233 INDIANAPOLIS BLVD
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:IN
Mailing Address - Zip Code:46324-2213
Mailing Address - Country:US
Mailing Address - Phone:219-844-1155
Mailing Address - Fax:219-844-2327
Practice Address - Street 1:7233 INDIANAPOLIS BLVD
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:IN
Practice Address - Zip Code:46324-2213
Practice Address - Country:US
Practice Address - Phone:219-844-1155
Practice Address - Fax:219-844-2327
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN17001145A332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000498611Medicare UPIN