Provider Demographics
NPI:1124196761
Name:TRI-CITY AUDIOLOGY, LLC
Entity Type:Organization
Organization Name:TRI-CITY AUDIOLOGY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:L
Authorized Official - Last Name:MCBRIDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-981-3384
Mailing Address - Street 1:6550 E BROADWAY RD
Mailing Address - Street 2:206
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206-1732
Mailing Address - Country:US
Mailing Address - Phone:480-981-3384
Mailing Address - Fax:480-924-8944
Practice Address - Street 1:6553 E BAYWOOD AVE STE 104
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-1753
Practice Address - Country:US
Practice Address - Phone:480-981-3384
Practice Address - Fax:480-924-8944
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-01
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ364231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty