Provider Demographics
NPI:1467602433
Name:KS HEALTHLINE, LLC
Entity type:Organization
Organization Name:KS HEALTHLINE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
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
Authorized Official - Phone:844-432-7483
Mailing Address - Street 1:4406 E MAIN ST STE 103
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85205-7910
Mailing Address - Country:US
Mailing Address - Phone:480-242-6247
Mailing Address - Fax:800-682-9127
Practice Address - Street 1:4406 E MAIN ST STE 103
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85205-7910
Practice Address - Country:US
Practice Address - Phone:480-242-6247
Practice Address - Fax:800-682-9127
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-25
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
231HA2500X, 231H00000X
AZHAD4173237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
No231HA2500XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology SupplierGroup - Single Specialty
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0309222OtherSTATE OF WASHINGTON DEPARTMENT OF LABOR
AZAZ0307340OtherBLUE CROSS BLUE SHIELD OF ARIZONA