Provider Demographics
NPI:1770857781
Name:TRINITY HEARING CENTER, INC.
Entity type:Organization
Organization Name:TRINITY HEARING CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRATARY/TRES.
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:LOBROVICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-522-0500
Mailing Address - Street 1:2700 S WOODLANDS VILLAGE BLVD
Mailing Address - Street 2:SUITE 300-409
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86001-7114
Mailing Address - Country:US
Mailing Address - Phone:928-522-0500
Mailing Address - Fax:855-433-1122
Practice Address - Street 1:1330 N RIM DR
Practice Address - Street 2:SUITE B
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86001-3134
Practice Address - Country:US
Practice Address - Phone:928-522-0500
Practice Address - Fax:855-433-1122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-08
Last Update Date:2014-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZDA1156231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty