Provider Demographics
NPI:1043602790
Name:GIRAFFE HEARING INC
Entity Type:Organization
Organization Name:GIRAFFE HEARING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:L
Authorized Official - Last Name:ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:HAD
Authorized Official - Phone:520-625-9545
Mailing Address - Street 1:267 W DUVAL RD #101
Mailing Address - Street 2:
Mailing Address - City:GREEN VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85614-4344
Mailing Address - Country:US
Mailing Address - Phone:520-625-9545
Mailing Address - Fax:520-207-3473
Practice Address - Street 1:267 W DUVAL RD #101
Practice Address - Street 2:
Practice Address - City:GREEN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85614-4344
Practice Address - Country:US
Practice Address - Phone:520-625-9545
Practice Address - Fax:520-207-3473
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-04
Last Update Date:2015-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZHAD1090332S00000X
AZHAD6180332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZP030730OtherBLUE CROSS BLUE SHIELD OF AZ