Provider Demographics
NPI:1659726958
Name:ALL AZ HEARING LLC
Entity Type:Organization
Organization Name:ALL AZ HEARING LLC
Other - Org Name:FOUNTAIN HILLS HEARING HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ADELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:CORDOVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-326-1055
Mailing Address - Street 1:17100 E SHEA BLVD
Mailing Address - Street 2:616
Mailing Address - City:FOUNTAIN HILLS
Mailing Address - State:AZ
Mailing Address - Zip Code:85268-6625
Mailing Address - Country:US
Mailing Address - Phone:480-372-8383
Mailing Address - Fax:480-878-5045
Practice Address - Street 1:17100 E SHEA BLVD
Practice Address - Street 2:616
Practice Address - City:FOUNTAIN HILLS
Practice Address - State:AZ
Practice Address - Zip Code:85268-6625
Practice Address - Country:US
Practice Address - Phone:480-372-8383
Practice Address - Fax:480-878-5045
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-25
Last Update Date:2016-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZHADR9082237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZHADR9082OtherHEARING AID DISPENSER LICENSE