Healthcare Provider Details

I. General information

NPI: 1871824565
Provider Name (Legal Business Name): DESERT HEARING CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/20/2010
Last Update Date: 05/12/2021
Certification Date: 04/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1423 S HIGLEY RD STE 119
MESA AZ
85206-3450
US

IV. Provider business mailing address

1423 S HIGLEY RD STE 119
MESA AZ
85206-3450
US

V. Phone/Fax

Practice location:
  • Phone: 480-985-2544
  • Fax: 480-985-7198
Mailing address:
  • Phone: 480-985-2544
  • Fax: 480-985-7198

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number1532
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number
License Number State

VIII. Authorized Official

Name: GENE K. ERICKSON
Title or Position: OWNER
Credential:
Phone: 480-985-2544