Provider Demographics
NPI:1184035131
Name:BEULAH'S HEARING AID CENTER, LLC
Entity Type:Organization
Organization Name:BEULAH'S HEARING AID CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/HEARING INSTRUMENT SPECIALIST
Authorized Official - Prefix:MS
Authorized Official - First Name:BEULAH
Authorized Official - Middle Name:N
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:HEARING INSTRUMENT S
Authorized Official - Phone:606-676-0013
Mailing Address - Street 1:23 EURY LN
Mailing Address - Street 2:SUITE 5
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42501-4115
Mailing Address - Country:US
Mailing Address - Phone:606-676-0013
Mailing Address - Fax:606-676-0058
Practice Address - Street 1:23 EURY LN
Practice Address - Street 2:SUITE 5
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42501-4115
Practice Address - Country:US
Practice Address - Phone:606-676-0013
Practice Address - Fax:606-676-0058
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-13
Last Update Date:2014-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0887237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty