Healthcare Provider Details

I. General information

NPI: 1518947829
Provider Name (Legal Business Name): ARIZONA HEARCARE NETWORK, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/20/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13934 N 59TH AVE SUITE 120
GLENDALE AZ
85306-4167
US

IV. Provider business mailing address

PO BOX 6735
GOODYEAR AZ
85338-0629
US

V. Phone/Fax

Practice location:
  • Phone: 602-439-4321
  • Fax: 623-580-9396
Mailing address:
  • Phone: 602-439-4321
  • Fax: 623-580-9396

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License NumberHAD1506
License Number StateAZ

VIII. Authorized Official

Name: DR. STEPHEN F TEODORO
Title or Position: PRESIDENT
Credential: AU.D, FAAA
Phone: 602-866-0147