Provider Demographics
NPI:1003160094
Name:BEAULIEU HEARING CENTER INC.
Entity Type:Organization
Organization Name:BEAULIEU HEARING CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:BEAULIEU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-756-6337
Mailing Address - Street 1:2112 BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:NORTH BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97459-2330
Mailing Address - Country:US
Mailing Address - Phone:541-756-6337
Mailing Address - Fax:541-751-9908
Practice Address - Street 1:2112 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:NORTH BEND
Practice Address - State:OR
Practice Address - Zip Code:97459-2330
Practice Address - Country:US
Practice Address - Phone:541-756-6337
Practice Address - Fax:541-751-9908
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-30
Last Update Date:2012-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORHAS-P-1002441237700000X
ORHAS-P-542819237700000X
ORHAS-P-519608237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty