Provider Demographics
NPI:1932248333
Name:HEAR MAX PLLC
Entity Type:Organization
Organization Name:HEAR MAX PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:W
Authorized Official - Last Name:LAZICH
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:888-494-2140
Mailing Address - Street 1:13403 FOREST SPRINGS DR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40245-2077
Mailing Address - Country:US
Mailing Address - Phone:888-494-2140
Mailing Address - Fax:888-511-0265
Practice Address - Street 1:2308 SYCAMORE AVE
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40206-2421
Practice Address - Country:US
Practice Address - Phone:502-721-0515
Practice Address - Fax:888-511-0265
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-05
Last Update Date:2020-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200482320AMedicaid
IN200482320AMedicaid