MEDICARE: MERCY HEALTH - ST VINCENT MEDICAL CENTER LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	282NC2000X	Children's Hospital	35057799	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184629115
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MERCY HEALTH - ST VINCENT MEDICAL CENTER LLC

Provider Business Mailing Address
First Line	:	2222 CHERRY ST
Second Line	:	STE 1100
City	:	TOLEDO
State	:	OH
Zip	:	43608-2682
Country	:	US
Telephone Number	:	419-251-8052
Fax Number	:	419-251-3878

Provider Business Practice Location Address
First Line	:	2222 CHERRY ST
Second Line	:	STE 1100
City	:	TOLEDO
State	:	OH
Zip	:	43608-2682
Country	:	US
Telephone Number	:	419-251-8052
Fax Number	:	419-251-3878

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. RICHARD EVENS
Credential	:
Telephone Number	:	419-251-3592

Provider Enumeration Date	:	06/16/2005
Last Update Date	:	01/25/2022

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