Provider Demographics
NPI:1073273918
Name:G4 HEARING INC
Entity Type:Organization
Organization Name:G4 HEARING INC
Other - Org Name:BELTONE MID-ATLANTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:JORDAN
Authorized Official - Last Name:MCMILLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-830-1117
Mailing Address - Street 1:10401 OLD GEORGETOWN RD STE 102
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-1911
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10401 OLD GEORGETOWN RD STE 102
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-1911
Practice Address - Country:US
Practice Address - Phone:618-830-1117
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-20
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1811657869OtherNPI