Provider Demographics
NPI:1740305903
Name:LUEBBE HEARING SERVICES
Entity type:Organization
Organization Name:LUEBBE HEARING SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:LOU
Authorized Official - Last Name:GEARHART
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:740-474-8475
Mailing Address - Street 1:210 SHARON RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:CIRCLEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43113-1498
Mailing Address - Country:US
Mailing Address - Phone:740-474-8475
Mailing Address - Fax:740-477-2430
Practice Address - Street 1:210 SHARON RD
Practice Address - Street 2:SUITE 1
Practice Address - City:CIRCLEVILLE
Practice Address - State:OH
Practice Address - Zip Code:43113-1498
Practice Address - Country:US
Practice Address - Phone:740-474-8475
Practice Address - Fax:740-477-2430
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2008-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHA00304231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0048022Medicaid
OH0592185Medicaid
OH0549961Medicare PIN
OH0592185Medicaid