Individual ProviderAnthony BrusnahanStudent in an Organized Health Care Education/Training ProgramStudent, Health CarePractice Address128 E. Apple St., Wche 7th Floor, Dayton, OH 45409(567) 224-1254(440) 227-3265PECOS EnrollmentBased on the most recent information from CMS, provider Anthony Brusnahan is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 8 days ago.Profile DetailsProvider ID1881228260Provider TypeIndividualFull NameBrusnahan, AnthonyCredentialDOGenderMaleSole ProprietorNoEnumeration Date2/25/2020Last Updated5/27/2020Contact InformationPractice LocationPractice Address128 E. Apple St., Wche 7th Floor, Dayton, OH 45409Phone(567) 224-1254FaxUnlisted FaxMailing LocationMailing Address771 Treasury Dr Apt I, Dayton, OH 45429-6232Phone(440) 227-3265FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode390200000XPrimaryDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicense58.031756OhioCode171000000XDescriptionMilitary Health Care ProviderOther Service ProvidersLicense58.031756OhioCode208600000XDescriptionSurgeryAllopathic & Osteopathic PhysiciansLicense58.031756Ohio