Organization
BRAD MCMILLIN INC
Active
Other names
BELTONE HEARING AID SERVICE
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PATTY L MCCUBBINS (ACCOUNTS RECEIVABLE)
(618) 624-4471
Entity
Organization
Contact information
Practice address
3142 NAMEOKI RD, GRANITE CITY, IL 62040-5013
(618) 451-1900
(618) 451-1918
Mailing address
1415 WEST HIGHWAY 50, O'FALLON, IL 62269
(618) 624-4471
(618) 624-4496
Taxonomy
Speciality
Code
Description
License number
State
332S00000X
Hearing Aid Equipment
Primary
IL 2792
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8215212
BLUE CROSS BLUESHIELD OF IL
IL
Enumeration date
08/13/2008
Last updated
04/24/2009
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