Provider Demographics
NPI:1093466088
Name:LUNSFORD AUDIOLOGY, LLC
Entity Type:Organization
Organization Name:LUNSFORD AUDIOLOGY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:LUNSFORD
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:317-201-9558
Mailing Address - Street 1:7159 SPAYSIDE DR N
Mailing Address - Street 2:
Mailing Address - City:NOBLESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46062-4110
Mailing Address - Country:US
Mailing Address - Phone:317-201-9558
Mailing Address - Fax:
Practice Address - Street 1:121 E 3RD ST STE C
Practice Address - Street 2:
Practice Address - City:RUSHVILLE
Practice Address - State:IN
Practice Address - Zip Code:46173-2209
Practice Address - Country:US
Practice Address - Phone:317-201-9558
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-12
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231HA2400XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology PractitionerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN1457661704Medicaid