Healthcare Provider Details

I. General information

NPI: 1174117634
Provider Name (Legal Business Name): HOMETOWN HEARING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/25/2021
Last Update Date: 06/10/2021
Certification Date: 06/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

312 N ALMA SCHOOL RD STE 7
CHANDLER AZ
85224-4354
US

IV. Provider business mailing address

7674 EVEREST LN N
MAPLE GROVE MN
55311-3720
US

V. Phone/Fax

Practice location:
  • Phone: 480-899-6819
  • Fax:
Mailing address:
  • Phone: 612-638-7987
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number
License Number State

VIII. Authorized Official

Name: BRANDON MARCUS
Title or Position: PRESIDENT
Credential:
Phone: 612-638-7987