Provider Demographics
NPI:1336113711
Name:METRO HEARING SEVICIES
Entity Type:Organization
Organization Name:METRO HEARING SEVICIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:FRANCIS
Authorized Official - Last Name:TEODORO
Authorized Official - Suffix:
Authorized Official - Credentials:AUD, 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:2006-02-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZDA237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZDA529OtherDISPENSING AUDIOLOGY
AZDA529OtherDISPENSING AUDIOLOGY
S16329Medicare UPIN