Provider Demographics
NPI:1770753634
Name:HEARING SOLUTIONS OF ARIZONA LLC
Entity type:Organization
Organization Name:HEARING SOLUTIONS OF ARIZONA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:K
Authorized Official - Last Name:VENKATESH
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:480-833-4330
Mailing Address - Street 1:2501 E SOUTHERN AVE STE 21
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-7667
Mailing Address - Country:US
Mailing Address - Phone:480-833-4330
Mailing Address - Fax:480-833-1902
Practice Address - Street 1:2501 E SOUTHERN AVE STE 21
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-7667
Practice Address - Country:US
Practice Address - Phone:480-833-4330
Practice Address - Fax:480-833-1902
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-06
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZDA1670237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZP50449Medicare UPIN
AZ69229Medicare PIN