Provider Demographics
NPI:1578978458
Name:VCV HEARING LABS LLC
Entity Type:Organization
Organization Name:VCV HEARING LABS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNTS RECIEVABLE AND PAYABLE
Authorized Official - Prefix:MRS
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:VAN SHAAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-965-4873
Mailing Address - Street 1:1234 E AIRPORT ROAD
Mailing Address - Street 2:
Mailing Address - City:SAFFORD
Mailing Address - State:AZ
Mailing Address - Zip Code:85546
Mailing Address - Country:US
Mailing Address - Phone:928-965-4873
Mailing Address - Fax:
Practice Address - Street 1:1234 E AIRPORT RD
Practice Address - Street 2:
Practice Address - City:SAFFORD
Practice Address - State:AZ
Practice Address - Zip Code:85546-9147
Practice Address - Country:US
Practice Address - Phone:928-965-4873
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-30
Last Update Date:2015-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332S00000XSuppliersHearing Aid EquipmentGroup - Single Specialty