1265416218 NPI number — BELTONE HEARING AID CENTER

Table of content: (NPI 1265416218)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265416218 NPI number — BELTONE HEARING AID CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BELTONE HEARING AID CENTER
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:
CENTRAL CAROLINA AUDIOLOGICAL ASSOCIATES
Provider Other Organization Name Type Code:
5
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:
1265416218
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/19/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
751 BETHESDA RD
Provider Second Line Business Mailing Address:
SUITE 100
Provider Business Mailing Address City Name:
WINSTON SALEM
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27103-3301
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
336-774-1113
Provider Business Mailing Address Fax Number:
336-774-1467

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
751 BETHESDA RD
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
WINSTON SALEM
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27103-3301
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
336-774-1113
Provider Business Practice Location Address Fax Number:
336-774-1467
Provider Enumeration Date:
12/02/2005

Additional Information

Authorized Official

Authorized Official Last Name:
BEDSAUL
Authorized Official First Name:
TRINA
Authorized Official Middle Name:
RENEE
Authorized Official Title or Position:
OWNER DOCTOR OF AUDIOLOGY
Authorized Official Telephone Number:
336-774-1113

Provider Taxonomy Codes

  • Taxonomy code: 231H00000X , with the licence number:  2601 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 231HA2400X , with the licence number: 2601 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 237600000X , with the licence number: 2601/690 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 237700000X , with the licence number: 690/226 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 7412001 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 561729201 . This is a "ID NUMBER" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 7211385 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0126V . This is a "BCBS OF NC" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 3404118 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 56152 . This is a "PARTNERS" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com