Provider Demographics
NPI:1194103911
Name:BELTONE CAROLINA/VIRGINIA
Entity type:Organization
Organization Name:BELTONE CAROLINA/VIRGINIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGED CARE COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:GAIL
Authorized Official - Middle Name:
Authorized Official - Last Name:COLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-921-3320
Mailing Address - Street 1:931 JEFFERSON BLVD
Mailing Address - Street 2:SUITE 2001
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-2234
Mailing Address - Country:US
Mailing Address - Phone:401-921-3320
Mailing Address - Fax:401-921-1993
Practice Address - Street 1:8901 THREE CHOPT RD
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23229-4643
Practice Address - Country:US
Practice Address - Phone:804-754-3600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-13
Last Update Date:2015-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2101002041332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment