Organization
BRAD MCMILLIN INC
Active
Other names
BELTONE HEARING AID SERVICE
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PATTY LEE MCCUBBINS (ACT REC MANAGER)
(618) 242-4920
Entity
Organization
Contact information
Practice address
1415 W US HIGHWAY 50, O FALLON, IL 62269-1618
(618) 624-4471
(618) 624-4496
Mailing address
1415 W US HIGHWAY 50, O FALLON, IL 62269-1618
(618) 624-4471
(618) 624-4496
Taxonomy
Speciality
Code
Description
License number
State
237600000X
Audiologist-Hearing Aid Fitter
Primary
3184
IL
332S00000X
Hearing Aid Equipment
2023-7529
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8215212
BCBS OF ILLINOIS
IL
Enumeration date
02/12/2007
Last updated
12/26/2014
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