1770100992 NPI number — INMAN AUDIOLOGY & CONSULTING LLC

Table of content: (NPI 1770100992)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1770100992 NPI number — INMAN AUDIOLOGY & CONSULTING LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
INMAN AUDIOLOGY & CONSULTING LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1770100992
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/03/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1418 W ELMWOOD AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CLAWSON
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48017-1362
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
810-304-3729
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1651 W BIG BEAVER RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TROY
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48084-3501
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
248-839-5429
Provider Business Practice Location Address Fax Number:
248-244-8604
Provider Enumeration Date:
07/03/2020

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
INMAN
Authorized Official First Name:
TIFFANY
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER/DIRECTOR OF AUDIOLOGY
Authorized Official Telephone Number:
248-839-5429

Provider Taxonomy Codes

  • Taxonomy code: 231H00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)