Healthcare Provider Details

I. General information

NPI: 1982866422
Provider Name (Legal Business Name): ARIZONA HEARING AID & AUDIOLOGY ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2008
Last Update Date: 06/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10404 W COGGINS DR SUITE 101
SUN CITY AZ
85351-3437
US

IV. Provider business mailing address

PO BOX 7007
ROCHESTER MN
55903-7007
US

V. Phone/Fax

Practice location:
  • Phone: 623-974-9666
  • Fax:
Mailing address:
  • Phone: 507-254-6931
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number5784
License Number StateAZ

VIII. Authorized Official

Name: MR. DOUGLAS C FREEMAN
Title or Position: DIRECTOR OF AUDIOLOGY
Credential:
Phone: 507-254-6931