Provider Demographics
NPI:1982866422
Name:ARIZONA HEARING AID & AUDIOLOGY ASSOCIATES LLC
Entity Type:Organization
Organization Name:ARIZONA HEARING AID & AUDIOLOGY ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF AUDIOLOGY
Authorized Official - Prefix:MR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:C
Authorized Official - Last Name:FREEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-254-6931
Mailing Address - Street 1:PO BOX 7007
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55903-7007
Mailing Address - Country:US
Mailing Address - Phone:507-254-6931
Mailing Address - Fax:
Practice Address - Street 1:10404 W COGGINS DR
Practice Address - Street 2:SUITE 101
Practice Address - City:SUN CITY
Practice Address - State:AZ
Practice Address - Zip Code:85351-3437
Practice Address - Country:US
Practice Address - Phone:623-974-9666
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-26
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5784332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies