Healthcare Provider Details

I. General information

NPI: 1356681316
Provider Name (Legal Business Name): NORTHLAND HEARING CENTERS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2013
Last Update Date: 07/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10404 W COGGINS DR SUITE 110
SUN CITY AZ
85351-3437
US

IV. Provider business mailing address

1001 E. SUNSET ROAD UNIT #96595
LAS VEGAS NV
89193-1246
US

V. Phone/Fax

Practice location:
  • Phone: 623-974-9666
  • Fax:
Mailing address:
  • Phone: 702-798-0113
  • Fax: 866-291-5242

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberBHAD8207
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberBHAD8207
License Number StateAZ

VIII. Authorized Official

Name: STEVEN L RICHARDS
Title or Position: VICE PRESIDENT
Credential:
Phone: 800-328-8602