MEDICARE: PURTONE HEARING CENTERS LLC

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	237700000X	Hearing Instrument Specialist	HAD4599	AZ
2	332S00000X	Hearing Aid Equipment	HAD4599	AZ

General Provider Information

NPI Number	:	1770737165
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PURTONE HEARING CENTERS LLC

Provider Business Mailing Address
First Line	:	20350 N CAVE CREEK RD
Second Line	:	SUITE 130
City	:	PHOENIX
State	:	AZ
Zip	:	85024-1283
Country	:	US
Telephone Number	:	602-971-3900
Fax Number	:

Provider Business Practice Location Address
First Line	:	20350 N CAVE CREEK RD
Second Line	:	SUITE 130
City	:	PHOENIX
State	:	AZ
Zip	:	85024-1283
Country	:	US
Telephone Number	:	602-971-3900
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. EDWARD ANTON MAZNIO
Credential	:	HIS
Telephone Number	:	623-877-9900

Provider Enumeration Date	:	11/11/2008
Last Update Date	:	11/11/2008

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