Provider Demographics
NPI:1336701242
Name:BRIDGETOWN HEALTH CARE LLC
Entity Type:Organization
Organization Name:BRIDGETOWN HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSEL
Authorized Official - Prefix:MR
Authorized Official - First Name:GEOFFREY
Authorized Official - Middle Name:EVERETT
Authorized Official - Last Name:WEBSTER
Authorized Official - Suffix:
Authorized Official - Credentials:ESQ
Authorized Official - Phone:614-461-1156
Mailing Address - Street 1:17 S HIGH ST STE 770
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43215-3450
Mailing Address - Country:US
Mailing Address - Phone:614-461-1156
Mailing Address - Fax:614-461-7168
Practice Address - Street 1:4307 BRIDGETOWN RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45211-4427
Practice Address - Country:US
Practice Address - Phone:513-598-8000
Practice Address - Fax:513-574-7424
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-01
Last Update Date:2019-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2842NOtherLICENSE