Provider Demographics
NPI:1912530833
Name:YOUR COMPLETE SOURCE, PLLC
Entity Type:Organization
Organization Name:YOUR COMPLETE SOURCE, PLLC
Other - Org Name:HEARITE CHANDLER HEARING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/ HIS, AUDIOLOGY / AUDIOLOGIST
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:ERIC
Authorized Official - Last Name:LINEWEAVER
Authorized Official - Suffix:
Authorized Official - Credentials:HIS / AUD
Authorized Official - Phone:844-432-7483
Mailing Address - Street 1:312 N ALMA SCHOOL RD STE 7
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-4354
Mailing Address - Country:US
Mailing Address - Phone:480-899-6819
Mailing Address - Fax:
Practice Address - Street 1:2040 S ALMA SCHOOL RD STE 10
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85286-7076
Practice Address - Country:US
Practice Address - Phone:480-242-6247
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-19
Last Update Date:2022-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty
No332S00000XSuppliersHearing Aid EquipmentGroup - Single Specialty