Provider Demographics
NPI:1760761332
Name:BLUE GIRAFFE LLC
Entity Type:Organization
Organization Name:BLUE GIRAFFE LLC
Other - Org Name:LIFESTYLE HEARING SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:BYRON
Authorized Official - Middle Name:L
Authorized Official - Last Name:PATTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-323-0099
Mailing Address - Street 1:6479 E 22ND ST
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85710-5115
Mailing Address - Country:US
Mailing Address - Phone:520-323-0099
Mailing Address - Fax:520-290-6905
Practice Address - Street 1:6479 E 22ND ST
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85710-5115
Practice Address - Country:US
Practice Address - Phone:520-323-0099
Practice Address - Fax:520-290-6905
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-12
Last Update Date:2011-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZBHAD1362261QH0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech