Provider Demographics
NPI:1023909637
Name:BEARHAVEN HOLDINGS LLC
Entity type:Organization
Organization Name:BEARHAVEN HOLDINGS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:SULLIVAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-403-4158
Mailing Address - Street 1:5085 HAMPTON FARMS DR
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30068-4825
Mailing Address - Country:US
Mailing Address - Phone:770-884-8485
Mailing Address - Fax:928-504-1122
Practice Address - Street 1:5085 HAMPTON FARMS DR
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30068-4825
Practice Address - Country:US
Practice Address - Phone:770-884-8485
Practice Address - Fax:928-504-1122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-11
Last Update Date:2025-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies