Provider Demographics
NPI:1881668663
Name:EDITH & HENRY HEUSER HEARING INSTITUTE
Entity Type:Organization
Organization Name:EDITH & HENRY HEUSER HEARING INSTITUTE
Other - Org Name:HEUSER HEARING INSTITUTE
Other - Org Type:Other Name
Authorized Official - Title/Position:BILLING/CREDENTIALING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:C
Authorized Official - Last Name:LOCKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-371-9910
Mailing Address - Street 1:111 E KENTUCKY ST
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40203-2793
Mailing Address - Country:US
Mailing Address - Phone:502-371-9910
Mailing Address - Fax:502-515-3325
Practice Address - Street 1:117 E KENTUCKY ST
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40203-2793
Practice Address - Country:US
Practice Address - Phone:502-371-9910
Practice Address - Fax:502-515-3325
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-16
Last Update Date:2020-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY70900642Medicaid
KY6855Medicare PIN