Provider Demographics
NPI:1225244387
Name:ADVANCED HEARING TECHNOLOGIES INC.
Entity Type:Organization
Organization Name:ADVANCED HEARING TECHNOLOGIES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INSURANCE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MOLLY
Authorized Official - Middle Name:M
Authorized Official - Last Name:MITTENDORF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:260-426-4138
Mailing Address - Street 1:10437 ILLINOIS RD
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46814-9181
Mailing Address - Country:US
Mailing Address - Phone:260-426-4138
Mailing Address - Fax:260-426-1928
Practice Address - Street 1:10437 ILLINOIS RD.
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46814-9181
Practice Address - Country:US
Practice Address - Phone:260-426-4138
Practice Address - Fax:260-426-1928
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-15
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment