Provider Demographics
NPI:1093920282
Name:PROFESSIONAL HEARING MANAGEMENT INC
Entity Type:Organization
Organization Name:PROFESSIONAL HEARING MANAGEMENT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:A
Authorized Official - Last Name:DICKEY
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:219-464-9580
Mailing Address - Street 1:2601 BEECH ST
Mailing Address - Street 2:
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46383-6008
Mailing Address - Country:US
Mailing Address - Phone:219-464-9580
Mailing Address - Fax:219-464-0640
Practice Address - Street 1:2601 BEECH ST
Practice Address - Street 2:
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46383-6008
Practice Address - Country:US
Practice Address - Phone:219-464-9580
Practice Address - Fax:219-464-0640
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN23001381A237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN5694577OtherAETNA INSURANCE CO
IN000000085445OtherANTHEM BLUE CROSS
IN01208OtherHEAR USA NECP
IN653800AMedicare ID - Type UnspecifiedMEDICARE