Provider Demographics
NPI:1053458083
Name:BRIAR HILL HEALTHCARE RES
Entity Type:Organization
Organization Name:BRIAR HILL HEALTHCARE RES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ANDERSON
Authorized Official - Middle Name:C
Authorized Official - Last Name:OHAMN
Authorized Official - Suffix:
Authorized Official - Credentials:LNHA
Authorized Official - Phone:440-632-5241
Mailing Address - Street 1:PO BOX 277
Mailing Address - Street 2:15950 PIERCE ST
Mailing Address - City:MIDDLEFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44062
Mailing Address - Country:US
Mailing Address - Phone:440-632-5241
Mailing Address - Fax:440-632-9362
Practice Address - Street 1:15950 PIERCE ST
Practice Address - Street 2:
Practice Address - City:MIDDLEFIELD
Practice Address - State:OH
Practice Address - Zip Code:44062
Practice Address - Country:US
Practice Address - Phone:440-632-5241
Practice Address - Fax:440-632-9362
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0040226Medicaid
4514490001OtherDME
365937Medicare ID - Type Unspecified