MEDICARE: HEARING SOLUTIONS OF ARIZONA LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	237600000X	Audiologist-Hearing Aid Fitter	DA1670	AZ

General Provider Information

NPI Number	:	1770753634
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEARING SOLUTIONS OF ARIZONA LLC

Provider Business Mailing Address
First Line	:	2501 E SOUTHERN AVE STE 21
Second Line	:
City	:	TEMPE
State	:	AZ
Zip	:	85282-7667
Country	:	US
Telephone Number	:	480-833-4330
Fax Number	:	480-833-1902

Provider Business Practice Location Address
First Line	:	2501 E SOUTHERN AVE STE 21
Second Line	:
City	:	TEMPE
State	:	AZ
Zip	:	85282-7667
Country	:	US
Telephone Number	:	480-833-4330
Fax Number	:	480-833-1902

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DEBRA K VENKATESH
Credential	:	AUD
Telephone Number	:	480-833-4330

Provider Enumeration Date	:	03/06/2008
Last Update Date	:	04/23/2008

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