Provider Demographics
NPI:1861855892
Name:AFFORDABLE HEARING GROUP, LLC
Entity Type:Organization
Organization Name:AFFORDABLE HEARING GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:KEENAN
Authorized Official - Suffix:
Authorized Official - Credentials:HIS
Authorized Official - Phone:574-387-4215
Mailing Address - Street 1:130 ROYS DR
Mailing Address - Street 2:STE A
Mailing Address - City:MISHAWAKA
Mailing Address - State:IN
Mailing Address - Zip Code:46544-1581
Mailing Address - Country:US
Mailing Address - Phone:574-387-4215
Mailing Address - Fax:574-387-4215
Practice Address - Street 1:130 ROYS DR
Practice Address - Street 2:STE A
Practice Address - City:MISHAWAKA
Practice Address - State:IN
Practice Address - Zip Code:46544-1581
Practice Address - Country:US
Practice Address - Phone:574-387-4215
Practice Address - Fax:574-387-4215
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-29
Last Update Date:2016-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN17001423A332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment