Provider Demographics
NPI:1619734654
Name:REXHILL LLC
Entity Type:Organization
Organization Name:REXHILL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:BRANHAM
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:330-819-8853
Mailing Address - Street 1:143 BOARDMAN CANFIELD RD STE 323
Mailing Address - Street 2:
Mailing Address - City:BOARDMAN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-4804
Mailing Address - Country:US
Mailing Address - Phone:330-728-1092
Mailing Address - Fax:
Practice Address - Street 1:755 BOARDMAN CANFIELD RD STE C1
Practice Address - Street 2:
Practice Address - City:BOARDMAN
Practice Address - State:OH
Practice Address - Zip Code:44512-4387
Practice Address - Country:US
Practice Address - Phone:330-728-1092
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-05
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction MedicineGroup - Single Specialty