Provider Demographics
NPI:1326174665
Name:LLOYD HEARING AID CORP
Entity Type:Organization
Organization Name:LLOYD HEARING AID CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES LLOYD HEARING AID CORP
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:M
Authorized Official - Last Name:PALMQUIST
Authorized Official - Suffix:
Authorized Official - Credentials:CERT HEARING INSTR S
Authorized Official - Phone:815-964-4191
Mailing Address - Street 1:PO BOX 7355
Mailing Address - Street 2:4435 MANCHESTER DRIVE
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61126-7355
Mailing Address - Country:US
Mailing Address - Phone:815-964-4191
Mailing Address - Fax:815-964-8378
Practice Address - Street 1:4435 MANCHESTER DR
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61109-1655
Practice Address - Country:US
Practice Address - Phone:815-964-4191
Practice Address - Fax:815-964-8378
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-23
Last Update Date:2011-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1851237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0010172016OtherBLUE CROSS BLUE SHIELD