Healthcare Provider Details

I. General information

NPI: 1477649937
Provider Name (Legal Business Name): WESTERN HEARING AID SERVICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6143 W. SUNNYSIDE DR
GLENDALE AZ
85304
US

IV. Provider business mailing address

P.O. BOX 6149
GLENDALE AZ
85312-6149
US

V. Phone/Fax

Practice location:
  • Phone: 602-469-7328
  • Fax:
Mailing address:
  • Phone: 602-469-7328
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number285
License Number StateAZ

VIII. Authorized Official

Name: ELLEN F ALLISON
Title or Position: PRESIDENT/HEARING AID DISPENSER
Credential:
Phone: 602-469-7328