Basic Information
| Provider Information | |||||||||
| NPI: | 1982866422 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ARIZONA HEARING AID & AUDIOLOGY ASSOCIATES LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 7007 | ||||||||
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| City: | ROCHESTER | ||||||||
| State: | MN | ||||||||
| PostalCode: | 559037007 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5072546931 | ||||||||
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| Practice Location | |||||||||
| Address1: | 10404 W COGGINS DR | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | SUN CITY | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 853513437 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6239749666 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/26/2008 | ||||||||
| LastUpdateDate: | 06/26/2008 | ||||||||
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| AuthorizedOfficialLastName: | FREEMAN | ||||||||
| AuthorizedOfficialFirstName: | DOUGLAS | ||||||||
| AuthorizedOfficialMiddleName: | C | ||||||||
| AuthorizedOfficialTitleorPosition: | DIRECTOR OF AUDIOLOGY | ||||||||
| AuthorizedOfficialTelephone: | 5072546931 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332B00000X | 5784 | AZ | Y | Suppliers | Durable Medical Equipment & Medical Supplies |
No ID Information.