Healthcare Provider Details

I. General information

NPI: 1306948617
Provider Name (Legal Business Name): B & P HEARING AID CO. INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/05/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2055 W HIGHWAY 50
FAIRVIEW HEIGHTS IL
62208
US

IV. Provider business mailing address

2055 W HIGHWAY 50
FAIRVIEW HEIGHTS IL
62208
US

V. Phone/Fax

Practice location:
  • Phone: 618-624-6485
  • Fax: 618-624-6702
Mailing address:
  • Phone: 618-624-6485
  • Fax: 618-624-6702

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number2748
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number2757
License Number StateIL

VIII. Authorized Official

Name: MR. JASON M PETTY
Title or Position: HEARING INSTRUMENT SPECIALIST/OWNER
Credential: HIS
Phone: 618-466-1227