Park Place Declarant

Primary specialty

Hearing Aid EquipmentTaxonomy code 332S00000X

License

HAD5806 Issued in AZ

Legal business name

PARK PLACE DECLARANT

Doing business as

Fabulous Hearing

Practice address

2105 McCulloch Blvd N
#2
Lake Havasu City, AZ 86403-6772

Phone

(702) 807-7931

Fax

(702) 398-3757

NPI assigned

Mar 26, 2009

Last updated

Mar 26, 2009By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Suzanne Kelly, MEMBER

Title

Owner

Phone

(702) 807-7931

Specialties & licenses 1

Addresses

Other names 1

• Fabulous Hearing Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1238025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1238025600000",
    "number": "1487896114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 224",
            "city": "LOGANDALE",
            "state": "NV",
            "postal_code": "890210224",
            "telephone_number": "702-807-7931",
            "fax_number": "702-398-3757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2105 MCCULLOCH BLVD N",
            "address_2": "#2",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864036772",
            "telephone_number": "702-807-7931",
            "fax_number": "702-398-3757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK PLACE DECLARANT",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-26",
        "last_updated": "2009-03-26",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "SUZANNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-807-7931",
        "authorized_official_credential": "MEMBER"
    },
    "taxonomies": [
        {
            "code": "332S00000X",
            "taxonomy_group": "",
            "desc": "Hearing Aid Equipment",
            "state": "AZ",
            "license": "HAD5806",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fabulous Hearing",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Hearing Aid Equipment in Lake Havasu City, AZ
• Providers in Lake Havasu City, AZ by specialty
• Hearing Aid Equipment in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.