Organization
BRAD MCMILLIN INC
Active
Other names
BELTONE HEARING AID SERVICE
Organization subpart
No
Provider details
NPI number
Authorized official
PATTY L MCCUBBINS (ACCOUNTS RECEIVABLE MANAGER)
(618) 624-4471
Entity
Organization
Contact information
Practice address
2045 ZUMBEHL RD, SAINT CHARLES, MO 63303-2723
(636) 724-8200
(636) 724-8219
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
MO2005036116
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8215212
BLUE CROSS BLUE SHIELD OF ILLINOIS
IL
Enumeration date
09/11/2008
Last updated
04/24/2009
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