Healthcare Provider Details

I. General information

NPI: 1104218189
Provider Name (Legal Business Name): VCV HEARING LABS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2015
Last Update Date: 02/26/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7862 N ORACLE RD
ORO VALLEY AZ
85704-6315
US

IV. Provider business mailing address

1234 E AIRPORT RD
SAFFORD AZ
85546-9147
US

V. Phone/Fax

Practice location:
  • Phone: 520-638-6378
  • Fax: 520-638-6378
Mailing address:
  • Phone: 928-965-0050
  • Fax: 888-399-5151

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number
License Number State

VIII. Authorized Official

Name: JONATHAN VAN SCOYK
Title or Position: OWNER
Credential:
Phone: 928-965-0050