Provider Demographics
NPI:1275579351
Name:MOHAVE HEARING LLC
Entity Type:Organization
Organization Name:MOHAVE HEARING LLC
Other - Org Name:MOHAVE BELTONE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JANET
Authorized Official - Middle Name:A
Authorized Official - Last Name:DEVORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-768-9020
Mailing Address - Street 1:5221 S HWY 95
Mailing Address - Street 2:SUITE 12
Mailing Address - City:FT MOHAVE
Mailing Address - State:AZ
Mailing Address - Zip Code:86426-9244
Mailing Address - Country:US
Mailing Address - Phone:928-768-9020
Mailing Address - Fax:928-768-9030
Practice Address - Street 1:5221 S HWY 95
Practice Address - Street 2:SUITE 12
Practice Address - City:FT MOHAVE
Practice Address - State:AZ
Practice Address - Zip Code:86426-9244
Practice Address - Country:US
Practice Address - Phone:928-768-9020
Practice Address - Fax:928-768-9030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ20096400-N332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment