Provider Demographics
NPI:1457002701
Name:PAIN AND AGING MANAGEMENT LLC
Entity Type:Organization
Organization Name:PAIN AND AGING MANAGEMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:BECK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:812-376-0700
Mailing Address - Street 1:PO BOX 26395
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-2014
Mailing Address - Country:US
Mailing Address - Phone:812-376-0700
Mailing Address - Fax:812-376-8625
Practice Address - Street 1:3740 S 4TH ST
Practice Address - Street 2:
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47802-5507
Practice Address - Country:US
Practice Address - Phone:812-238-3030
Practice Address - Fax:812-238-3040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-18
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies