Healthcare Provider Details

I. General information

NPI: 1194310854
Provider Name (Legal Business Name): CASMIN HEARING GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2021
Last Update Date: 12/19/2024
Certification Date: 12/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10893 N SCOTTSDALE RD STE 115
SCOTTSDALE AZ
85254-5279
US

IV. Provider business mailing address

10869 N SCOTTSDALE RD STE 103-147
SCOTTSDALE AZ
85254-5280
US

V. Phone/Fax

Practice location:
  • Phone: 480-687-8111
  • Fax: 480-716-9318
Mailing address:
  • Phone: 480-687-8111
  • Fax: 480-716-9318

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number
License Number State

VIII. Authorized Official

Name: KORY CASTRO
Title or Position: PRESIDENT
Credential:
Phone: 480-687-8111