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)
(618) 624-4471
Entity
Organization
Contact information
Practice address
2548 LEMAY FERRY ROAD, ST. LOUIS, MO 63125
(314) 416-1415
(314) 416-1495
Mailing address
1415 WEST HIGHWAY 50, O'FALLON, IL 62269
(618) 624-4471
(628) 624-4496
Taxonomy
Speciality
Code
Description
License number
State
332S00000X
Hearing Aid Equipment
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
154857
BC BS OF MISSOURI
MO
01
—
8215212
BC BS OF ILLINOIS
IL
Enumeration date
04/17/2007
Last updated
04/22/2009
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