Healthcare Provider Details

I. General information

NPI: 1568008399
Provider Name (Legal Business Name): BELTOPIA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/27/2019
Last Update Date: 12/27/2019
Certification Date: 12/27/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1721 MARION AVE
MATTOON IL
61938-5262
US

IV. Provider business mailing address

4142 S 7TH ST
TERRE HAUTE IN
47802-4123
US

V. Phone/Fax

Practice location:
  • Phone: 217-258-8000
  • Fax:
Mailing address:
  • Phone: 844-283-4357
  • Fax: 888-513-4286

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KARA GRAEBER
Title or Position: BILLING
Credential:
Phone: 720-382-4627