Provider Demographics
NPI:1851447627
Name:ZUDAC ENTERPRISES
Entity Type:Organization
Organization Name:ZUDAC ENTERPRISES
Other - Org Name:BELTONE HEARING CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:LARSON
Authorized Official - Suffix:
Authorized Official - Credentials:NHC HIS
Authorized Official - Phone:507-457-9830
Mailing Address - Street 1:52 W 3RD STREET
Mailing Address - Street 2:
Mailing Address - City:WINONA
Mailing Address - State:MN
Mailing Address - Zip Code:55987
Mailing Address - Country:US
Mailing Address - Phone:507-457-9830
Mailing Address - Fax:507-457-9834
Practice Address - Street 1:52 W 3RD STREET
Practice Address - Street 2:
Practice Address - City:WINONA
Practice Address - State:MN
Practice Address - Zip Code:55987
Practice Address - Country:US
Practice Address - Phone:507-457-9830
Practice Address - Fax:507-457-9834
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI42828800Medicaid
MN099D5BEOtherBLUE CROSS BLUE SHIELD