=====================================================
General NPI Number Information
=====================================================
NPI Number | 1578381307
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | OHSRH, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/01/2024
-----------------------------------------------------
Last Update Date | 12/08/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 13695 US HIGHWAY 1
-----------------------------------------------------
City | SEBASTIAN
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32958-3230
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 772-589-3186
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 13695 US HIGHWAY 1
-----------------------------------------------------
City | SEBASTIAN
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32958-3230
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 772-589-3186
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | SENIOR VICE PRESIDENT OF FINANCE
-----------------------------------------------------
Name | JOHN E MILLER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 321-843-3180
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 282N00000X
-----------------------------------------------------
Taxonomy Name | General Acute Care Hospital
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------