1376577965 NPI number — BEATTIE HEARING SERVICE INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1376577965 NPI number — BEATTIE HEARING SERVICE INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BEATTIE HEARING SERVICE INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
BELTONE HEARING AID CENTER
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1376577965
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4084 STATE ST
Provider Second Line Business Mailing Address:
PO BOX 3233
Provider Business Mailing Address City Name:
SAGINAW
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48605
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
989-793-7620
Provider Business Mailing Address Fax Number:
979-793-2044

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4084 STATE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAGINAW
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48605
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
989-793-7620
Provider Business Practice Location Address Fax Number:
979-793-2044
Provider Enumeration Date:
07/10/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BEATTIE
Authorized Official First Name:
DAVID
Authorized Official Middle Name:
ARTHUR
Authorized Official Title or Position:
PRESIDENT OWNER
Authorized Official Telephone Number:
989-793-7620

Provider Taxonomy Codes

  • Taxonomy code: 332S00000X , with the licence number:  000706 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 5013226 . This is a "HEALTH PLUS" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".




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