Provider Demographics
NPI:1083839666
Name:METRO HEARING ASSOCIATES, LLC
Entity Type:Organization
Organization Name:METRO HEARING ASSOCIATES, LLC
Other - Org Name:METRO HEARING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT OF COMPANY
Authorized Official - Prefix:MR
Authorized Official - First Name:DAN
Authorized Official - Middle Name:
Authorized Official - Last Name:TRIMBLE
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-A
Authorized Official - Phone:602-866-0147
Mailing Address - Street 1:13934 N 59TH AVE
Mailing Address - Street 2:SUITE # 120
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85306-4167
Mailing Address - Country:US
Mailing Address - Phone:602-866-0147
Mailing Address - Fax:602-547-9644
Practice Address - Street 1:13934 N 59TH AVE
Practice Address - Street 2:SUITE # 120
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85306-4167
Practice Address - Country:US
Practice Address - Phone:602-866-0147
Practice Address - Fax:602-547-9644
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2013-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZDA529231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ953423Medicaid
AZ953423Medicaid