Provider Demographics
NPI:1790347862
Name:CHOICE HEARING CENTERS
Entity Type:Organization
Organization Name:CHOICE HEARING CENTERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:
Authorized Official - Last Name:DEERBERG
Authorized Official - Suffix:
Authorized Official - Credentials:HIS
Authorized Official - Phone:317-371-3753
Mailing Address - Street 1:110 E CARMEL DR
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-2633
Mailing Address - Country:US
Mailing Address - Phone:317-793-8588
Mailing Address - Fax:
Practice Address - Street 1:110 E CARMEL DR
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-2633
Practice Address - Country:US
Practice Address - Phone:317-793-8588
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-28
Last Update Date:2019-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN1225225725OtherHIS