MEDICARE: ADVANCED AUDIOLOGY & HEARING AIDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	231H00000X	Audiologist	DA1870	AZ

General Provider Information

NPI Number	:	1710236104
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED AUDIOLOGY & HEARING AIDS

Provider Business Mailing Address
First Line	:	2450 S 4TH AVENUE SUITE 107
Second Line	:
City	:	YUMA
State	:	AZ
Zip	:	85364-8573
Country	:	US
Telephone Number	:	928-344-1556
Fax Number	:	928-317-3093

Provider Business Practice Location Address
First Line	:	2450 S 4TH AVE STE 107
Second Line	:
City	:	YUMA
State	:	AZ
Zip	:	85364-8557
Country	:	US
Telephone Number	:	928-344-1556
Fax Number	:	928-317-3093

Authorized Official
Title or Position	:	OWNER
Name	:	DR. CHRISTOPHER W COX
Credential	:	AU.D CCC-AUDIOLOGY
Telephone Number	:	928-344-1556

Provider Enumeration Date	:	08/31/2012
Last Update Date	:	08/31/2012

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