Provider Demographics
NPI:1477981991
Name:CHRISTOPHER E HOLBROOK SR
Entity Type:Organization
Organization Name:CHRISTOPHER E HOLBROOK SR
Other - Org Name:BEACON HOME MEDICAL SUPPLY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:E
Authorized Official - Last Name:HOLBROOK
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:740-259-0808
Mailing Address - Street 1:1630 COON HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:LUCASVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45648-8872
Mailing Address - Country:US
Mailing Address - Phone:740-259-0808
Mailing Address - Fax:740-259-4095
Practice Address - Street 1:1630 COON HOLLOW RD
Practice Address - Street 2:
Practice Address - City:LUCASVILLE
Practice Address - State:OH
Practice Address - Zip Code:45648-8872
Practice Address - Country:US
Practice Address - Phone:740-259-0808
Practice Address - Fax:740-259-4095
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-18
Last Update Date:2013-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHHMEL11495332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies