Provider Demographics
NPI:1992058275
Name:GRUSECKI AUDIOLOGY & HEARING AID
Entity type:Organization
Organization Name:GRUSECKI AUDIOLOGY & HEARING AID
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:GRUSECKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-583-1737
Mailing Address - Street 1:12133 W BELL RD STE 201
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85378-9408
Mailing Address - Country:US
Mailing Address - Phone:623-583-1737
Mailing Address - Fax:623-583-0607
Practice Address - Street 1:12133 W BELL RD STE 201
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85378-9408
Practice Address - Country:US
Practice Address - Phone:623-583-1737
Practice Address - Fax:623-583-0607
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-24
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Multi-Specialty