Provider Demographics
NPI:1639514268
Name:HRADCO ENTERPRISES LLC
Entity Type:Organization
Organization Name:HRADCO ENTERPRISES LLC
Other - Org Name:BBN CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:TINA
Authorized Official - Middle Name:
Authorized Official - Last Name:HRADEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-273-4148
Mailing Address - Street 1:89 WELLSLEY PL
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:OH
Mailing Address - Zip Code:44212-1346
Mailing Address - Country:US
Mailing Address - Phone:330-273-4148
Mailing Address - Fax:
Practice Address - Street 1:1839 PEARL RD
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:OH
Practice Address - Zip Code:44212-3256
Practice Address - Country:US
Practice Address - Phone:330-273-4148
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-09
Last Update Date:2013-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center