Provider Demographics
NPI:1790227205
Name:BELMONT HEARING CENTER LLC
Entity Type:Organization
Organization Name:BELMONT HEARING CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:GRUBBS
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:239-292-2485
Mailing Address - Street 1:128 W NIMS AVE
Mailing Address - Street 2:
Mailing Address - City:MT HOLLY
Mailing Address - State:NC
Mailing Address - Zip Code:28120-1839
Mailing Address - Country:US
Mailing Address - Phone:239-292-2485
Mailing Address - Fax:
Practice Address - Street 1:100 N MAIN ST
Practice Address - Street 2:SUITE 123
Practice Address - City:BELMONT
Practice Address - State:NC
Practice Address - Zip Code:28012-3104
Practice Address - Country:US
Practice Address - Phone:704-860-7795
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-15
Last Update Date:2016-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1053237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty