Provider Demographics
NPI:1912013079
Name:BARTLEYS HEARING AID CTR INC
Entity Type:Organization
Organization Name:BARTLEYS HEARING AID CTR INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:HAGEMEYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-482-6101
Mailing Address - Street 1:332 3RD AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:IN
Mailing Address - Zip Code:47546-3432
Mailing Address - Country:US
Mailing Address - Phone:812-482-6101
Mailing Address - Fax:812-634-7353
Practice Address - Street 1:332 3RD AVE STE 3
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:IN
Practice Address - Zip Code:47546-3432
Practice Address - Country:US
Practice Address - Phone:812-482-6101
Practice Address - Fax:812-634-7353
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-22
Last Update Date:2016-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN17001294A332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100224990Medicaid
22000000201147OtherANTHEM