Provider Demographics
NPI:1558871012
Name:AUDIBEL OF MUNCIE
Entity Type:Organization
Organization Name:AUDIBEL OF MUNCIE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:R
Authorized Official - Last Name:ROWE
Authorized Official - Suffix:
Authorized Official - Credentials:HAD
Authorized Official - Phone:765-287-1245
Mailing Address - Street 1:908 W MCGALLIARD RD STE 2
Mailing Address - Street 2:
Mailing Address - City:MUNCIE
Mailing Address - State:IN
Mailing Address - Zip Code:47303-1702
Mailing Address - Country:US
Mailing Address - Phone:765-287-1245
Mailing Address - Fax:765-288-4574
Practice Address - Street 1:908 W MCGALLIARD RD STE 2
Practice Address - Street 2:
Practice Address - City:MUNCIE
Practice Address - State:IN
Practice Address - Zip Code:47303-1702
Practice Address - Country:US
Practice Address - Phone:765-287-1245
Practice Address - Fax:765-288-4574
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-10
Last Update Date:2017-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN23002476A237600000X
IN17001152A237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Multi-Specialty
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200484570AMedicaid