MEDICARE: EHRHART FAMILY PRACTICE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2300X	Primary Care Clinic/Center

General Provider Information

NPI Number	:	1386140069
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EHRHART FAMILY PRACTICE LLC

Provider Business Mailing Address
First Line	:	PO BOX 483
Second Line	:
City	:	SOUTH WEBSTER
State	:	OH
Zip	:	45682-0483
Country	:	US
Telephone Number	:	740-778-1818
Fax Number	:	740-778-1819

Provider Business Practice Location Address
First Line	:	11016 MAIN ST
Second Line	:
City	:	SOUTH WEBSTER
State	:	OH
Zip	:	45682-7501
Country	:	US
Telephone Number	:	740-448-1818
Fax Number	:	740-778-1819

Authorized Official
Title or Position	:	OWNER/APRN
Name	:	BRIDGET MICHELE EHRHART BENNETT
Credential	:	APRN
Telephone Number	:	740-778-1818

Provider Enumeration Date	:	04/02/2018
Last Update Date	:	11/04/2025

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Directions to “EHRHART FAMILY PRACTICE LLC ” Practice Location

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