Provider Demographics
NPI:1225330426
Name:AZENT HEARING CENTRE LLC
Entity Type:Organization
Organization Name:AZENT HEARING CENTRE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RALPH
Authorized Official - Middle Name:E
Authorized Official - Last Name:BASSETT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:623-975-1660
Mailing Address - Street 1:13949 W MEEKER BLVD
Mailing Address - Street 2:SUITE C
Mailing Address - City:SUN CITY WEST
Mailing Address - State:AZ
Mailing Address - Zip Code:85375-4436
Mailing Address - Country:US
Mailing Address - Phone:623-975-0879
Mailing Address - Fax:623-975-1654
Practice Address - Street 1:13949 W MEEKER BLVD
Practice Address - Street 2:SUITE C
Practice Address - City:SUN CITY WEST
Practice Address - State:AZ
Practice Address - Zip Code:85375-4436
Practice Address - Country:US
Practice Address - Phone:623-975-0879
Practice Address - Fax:623-975-1654
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ARIZONA EAR NOSE AND THROAT PHYSICIANS PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-11-22
Last Update Date:2010-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ24954174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ397564OtherAHCCCS
AZ397564Medicaid
AZAZ0899410OtherBLUE CROSS BLUE SHIELD
AZ40016859OtherMEDICARE RAILROAD
AZ397564Medicaid