MEDICARE: AFFORDABLE HEARING NETWORKS 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	231H00000X	Audiologist
2	237700000X	Hearing Instrument Specialist

General Provider Information

NPI Number	:	1902185267
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AFFORDABLE HEARING NETWORKS LLC

Provider Business Mailing Address
First Line	:	4578 HIGHLAND DR
Second Line	:	270
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84117-4243
Country	:	US
Telephone Number	:	801-424-2849
Fax Number	:	801-274-2026

Provider Business Practice Location Address
First Line	:	4578 HIGHLAND DR
Second Line	:	270
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84117-4243
Country	:	US
Telephone Number	:	801-424-2849
Fax Number	:	801-274-2026

Authorized Official
Title or Position	:	VP OF OPERATIONS
Name	:	MR. SPENCER JAMES NANCE
Credential	:
Telephone Number	:	801-424-2849

Provider Enumeration Date	:	08/04/2011
Last Update Date	:	08/04/2011

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