Provider Demographics
NPI:1700800133
Name:PKC, INC.
Entity Type:Organization
Organization Name:PKC, INC.
Other - Org Name:BELTONE HEARING AID CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:CONLON
Authorized Official - Suffix:
Authorized Official - Credentials:BC-HIS
Authorized Official - Phone:863-698-1822
Mailing Address - Street 1:490 AVENUE K SE
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33880-4125
Mailing Address - Country:US
Mailing Address - Phone:863-294-8353
Mailing Address - Fax:863-299-0334
Practice Address - Street 1:490 AVENUE K SE
Practice Address - Street 2:
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33880-4125
Practice Address - Country:US
Practice Address - Phone:863-294-8353
Practice Address - Fax:863-299-0334
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAS1699237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLJ0507OtherBC/BS INSURANCE