Healthcare Provider Details

I. General information

NPI: 1841593456
Provider Name (Legal Business Name): HEARING ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/21/2010
Last Update Date: 12/21/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4001 N BUTLER AVE BLDG 5101
FARMINGTON NM
87401-2353
US

IV. Provider business mailing address

4001 N BUTLER AVE BLDG 5101
FARMINGTON NM
87401-2353
US

V. Phone/Fax

Practice location:
  • Phone: 505-326-2791
  • Fax: 505-564-2811
Mailing address:
  • Phone: 505-326-2791
  • Fax: 505-564-2811

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License NumberHAD5825
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number0702
License Number StateNM

VIII. Authorized Official

Name: CHESTER DAVID SAXON
Title or Position: HEARING INSTRUMENT SPECIALIST
Credential: HIS
Phone: 505-326-2791