Provider Demographics
NPI:1821490020
Name:TRI-STATE HEARING, LLC
Entity Type:Organization
Organization Name:TRI-STATE HEARING, LLC
Other - Org Name:BELTONE AUDIOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAKE
Authorized Official - Middle Name:T
Authorized Official - Last Name:HENDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-822-0700
Mailing Address - Street 1:2025 BUENA VISTA DR.
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35216-3701
Mailing Address - Country:US
Mailing Address - Phone:205-822-0700
Mailing Address - Fax:
Practice Address - Street 1:227 MARKET PLACE CONNECTOR
Practice Address - Street 2:
Practice Address - City:PEACHTREE CITY
Practice Address - State:GA
Practice Address - Zip Code:30269-3542
Practice Address - Country:US
Practice Address - Phone:770-487-9030
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-18
Last Update Date:2017-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAUD003986261QH0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech