Provider Demographics
NPI:1467602433
Name:KS HEALTHLINE, LLC
Entity Type:Organization
Organization Name:KS HEALTHLINE, LLC
Other - Org Name:CHANDLER HEARING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:LINEWEAVER
Authorized Official - Suffix:
Authorized Official - Credentials:BS, HIS
Authorized Official - Phone:480-227-8071
Mailing Address - Street 1:PO BOX 93133
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85070-3133
Mailing Address - Country:US
Mailing Address - Phone:480-227-8071
Mailing Address - Fax:
Practice Address - Street 1:312 N ALMA SCHOOL RD
Practice Address - Street 2:SUITE 8
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-4354
Practice Address - Country:US
Practice Address - Phone:480-899-6819
Practice Address - Fax:602-467-3186
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-25
Last Update Date:2017-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZBHAD4761237700000X
AZHAD4173237700000X
AZHAD4782237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0309222OtherSTATE OF WASHINGTON DEPARTMENT OF LABOR
AZAZ0307340OtherBLUE CROSS BLUE SHIELD OF ARIZONA