Provider Demographics
NPI:1871503573
Name:HOOSIER HEARING SOLUTIONS LLC
Entity Type:Organization
Organization Name:HOOSIER HEARING SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/AUDIOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:ROGERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-332-5633
Mailing Address - Street 1:1355 W BLOOMFIELD ROAD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47403-2052
Mailing Address - Country:US
Mailing Address - Phone:812-332-5633
Mailing Address - Fax:812-332-5671
Practice Address - Street 1:1355 W BLOOMFIELD ROAD
Practice Address - Street 2:SUITE 3
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47403-2052
Practice Address - Country:US
Practice Address - Phone:812-332-5633
Practice Address - Fax:812-332-5671
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-08
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN23002164A231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty