Provider Demographics
NPI:1629019666
Name:OHIOHEALTH BERGER HOSPITAL LLC
Entity Type:Organization
Organization Name:OHIOHEALTH BERGER HOSPITAL LLC
Other - Org Name:BERGER HOSPICE
Other - Org Type:Other Name
Authorized Official - Title/Position:CFO, OHIOHEALTH
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWNING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-544-4161
Mailing Address - Street 1:3430 OHIOHEALTH PKWY
Mailing Address - Street 2:FL 3 NORTH
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-1575
Mailing Address - Country:US
Mailing Address - Phone:614-544-4125
Mailing Address - Fax:
Practice Address - Street 1:610 NORTHRIDGE ROAD
Practice Address - Street 2:
Practice Address - City:CIRCLEVILLE
Practice Address - State:OH
Practice Address - Zip Code:43113-1181
Practice Address - Country:US
Practice Address - Phone:740-420-7950
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OHIOHEALTH BERGER HOSPITAL LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-09
Last Update Date:2020-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0907102Medicaid