Provider Demographics
NPI:1811493349
Name:HEROES OF HEARING, LLC
Entity type:Organization
Organization Name:HEROES OF HEARING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:BROADHEAD
Authorized Official - Suffix:
Authorized Official - Credentials:HIS
Authorized Official - Phone:520-230-3999
Mailing Address - Street 1:3275 W INA RD STE 117
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85741-2330
Mailing Address - Country:US
Mailing Address - Phone:520-230-3999
Mailing Address - Fax:888-240-3305
Practice Address - Street 1:3275 W INA RD STE 117
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85741-2330
Practice Address - Country:US
Practice Address - Phone:520-230-3999
Practice Address - Fax:888-240-3305
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-03
Last Update Date:2019-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZBHAD11141261QH0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech