Basic Information
| Provider Information | |||||||||
| NPI: | 1851464721 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | MERCY HEALTH-ALLEN HOSPITAL LLC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | MERCY HEALTH ALLEN HOSPITAL | ||||||||
| OtherOrganizationType: | 3 | ||||||||
| OtherLastName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 636569 | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452636569 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4409603983 | ||||||||
| FaxNumber: | 4409603359 | ||||||||
| Practice Location | |||||||||
| Address1: | 200 W LORAIN ST | ||||||||
| Address2: | |||||||||
| City: | OBERLIN | ||||||||
| State: | OH | ||||||||
| PostalCode: | 440741026 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4409693983 | ||||||||
| FaxNumber: | 4409603359 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/16/2006 | ||||||||
| LastUpdateDate: | 04/15/2019 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
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| AuthorizedOfficialLastName: | OLEY | ||||||||
| AuthorizedOfficialFirstName: | EDWIN | ||||||||
| AuthorizedOfficialMiddleName: | M | ||||||||
| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 4409603295 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | MERCY HEALTH LORAIN LLC | ||||||||
| AuthorizedOfficialNamePrefix: | MR. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 275N00000X | Y | Hospital Units | Medicare Defined Swing Bed Unit |
No ID Information.