1235239211 NPI number — MERCY HEALTH - ANDERSON HOSPITAL LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235239211 NPI number — MERCY HEALTH - ANDERSON HOSPITAL LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MERCY HEALTH - ANDERSON HOSPITAL LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
MERCY HOSPITAL ANDERSON
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1235239211
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/26/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 635915
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CINCINNATI
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45263-5915
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
513-624-4500
Provider Business Mailing Address Fax Number:
513-981-5728

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7500 STATE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CINCINNATI
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45255-2439
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
513-624-4500
Provider Business Practice Location Address Fax Number:
513-981-5728
Provider Enumeration Date:
09/22/2006

Additional Information

Authorized Official

Authorized Official Last Name:
JAMES
Authorized Official First Name:
KENNETH
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT MERCY HEALTH ANDERSON
Authorized Official Telephone Number:
513-732-8590

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 6639409 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1193 . This is a "OHIO DEPT. OF HEALTH" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".




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