Provider Demographics
NPI:1588023873
Name:RANDALL HEARING LLC
Entity Type:Organization
Organization Name:RANDALL HEARING LLC
Other - Org Name:BELTONE HEARING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RANDALL
Authorized Official - Middle Name:L
Authorized Official - Last Name:HOLYFIELD
Authorized Official - Suffix:SR
Authorized Official - Credentials:BC-HIS ACA
Authorized Official - Phone:970-292-8023
Mailing Address - Street 1:1135 N LINCOLN AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80537-4877
Mailing Address - Country:US
Mailing Address - Phone:970-292-8023
Mailing Address - Fax:970-292-8459
Practice Address - Street 1:1135 N LINCOLN AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80537-4877
Practice Address - Country:US
Practice Address - Phone:970-292-8023
Practice Address - Fax:970-292-8459
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-16
Last Update Date:2016-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COHA223332S00000X
CAHA7090332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment