Provider Demographics
NPI:1932593316
Name:HEARING CENTER OF SIERRA VISTA LLC
Entity Type:Organization
Organization Name:HEARING CENTER OF SIERRA VISTA LLC
Other - Org Name:AUDIOLOGY HEARING & BALANCE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:OMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:ROMERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-816-2958
Mailing Address - Street 1:203 SE PARK PLAZA DR
Mailing Address - Street 2:270
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98684-5886
Mailing Address - Country:US
Mailing Address - Phone:360-816-2958
Mailing Address - Fax:360-816-7156
Practice Address - Street 1:1989 FRONTAGE RD
Practice Address - Street 2:
Practice Address - City:SIERRA VISTA
Practice Address - State:AZ
Practice Address - Zip Code:85635-4698
Practice Address - Country:US
Practice Address - Phone:520-226-9660
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AUDIGY VENTURE GROUP LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-03-24
Last Update Date:2015-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty