Provider Demographics
NPI:1710277348
Name:ELLAG, INC.
Entity Type:Organization
Organization Name:ELLAG, INC.
Other - Org Name:BELTONE OF TRI CITIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TROY
Authorized Official - Middle Name:D
Authorized Official - Last Name:GREENWALD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-246-3800
Mailing Address - Street 1:2408 MEMORIAL BLVD
Mailing Address - Street 2:
Mailing Address - City:KINGSPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37664-3343
Mailing Address - Country:US
Mailing Address - Phone:423-246-3800
Mailing Address - Fax:423-288-1900
Practice Address - Street 1:2408 MEMORIAL BLVD
Practice Address - Street 2:
Practice Address - City:KINGSPORT
Practice Address - State:TN
Practice Address - Zip Code:37664-3343
Practice Address - Country:US
Practice Address - Phone:423-246-3800
Practice Address - Fax:423-288-1900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-16
Last Update Date:2011-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment