Provider Demographics
NPI:1609486976
Name:SUMMIT HEARING SOLUTIONS,INC.
Entity Type:Organization
Organization Name:SUMMIT HEARING SOLUTIONS,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THEODORE
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:BLANFORD
Authorized Official - Suffix:
Authorized Official - Credentials:HIS, ACA
Authorized Official - Phone:260-338-2942
Mailing Address - Street 1:927 E DUPONT RD
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46825-1551
Mailing Address - Country:US
Mailing Address - Phone:260-338-2942
Mailing Address - Fax:260-338-2504
Practice Address - Street 1:927 E DUPONT RD
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46825-1551
Practice Address - Country:US
Practice Address - Phone:260-338-2942
Practice Address - Fax:260-338-2504
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-03
Last Update Date:2020-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech