Healthcare Provider Details

I. General information

NPI: 1508541285
Provider Name (Legal Business Name): CONIFER HEARING AND TINNITUS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2023
Last Update Date: 08/16/2024
Certification Date: 08/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10791 KITTY DR STE B
CONIFER CO
80433-7748
US

IV. Provider business mailing address

36305 N GANTZEL RD STE 104
SAN TAN VALLEY AZ
85140-7326
US

V. Phone/Fax

Practice location:
  • Phone: 720-900-2266
  • Fax:
Mailing address:
  • Phone: 480-284-6004
  • Fax: 480-420-3659

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State
# 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: FALLON TRIMMINGS
Title or Position: BILLING/CREDENTIALING MANAGER
Credential:
Phone: 520-461-4948