Provider Demographics
NPI:1275773772
Name:BEAM INC.
Entity Type:Organization
Organization Name:BEAM INC.
Other - Org Name:MIRACLE EAR HEARING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:HEARING INSTRUMENT SPECIALIST
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:F
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:NBCHIS
Authorized Official - Phone:970-434-2220
Mailing Address - Street 1:3094 I-70 BUSINESS LOOP UNIT B
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81504-4425
Mailing Address - Country:US
Mailing Address - Phone:970-434-2220
Mailing Address - Fax:970-434-7955
Practice Address - Street 1:3094 I-70 BUSINESS LOOP UNIT B
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81504-4425
Practice Address - Country:US
Practice Address - Phone:970-434-2220
Practice Address - Fax:970-434-7955
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-24
Last Update Date:2009-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty