MEDICARE: MERCY HEALTH PARTNERS

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	313M00000X	Nursing Facility/Intermediate Care Facility		OH

General Provider Information

NPI Number	:	1407113434
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MERCY HEALTH PARTNERS

Provider Business Mailing Address
First Line	:	7148 CLOVERNOOK AVE.
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45231
Country	:	US
Telephone Number	:	513-240-6310
Fax Number	:

Provider Business Practice Location Address
First Line	:	7148 CLOVERNOOK AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45231-5567
Country	:	US
Telephone Number	:	531-240-6310
Fax Number	:

Authorized Official
Title or Position	:	STNA
Name	:	PROF. DERETHA LOGAN I
Credential	:
Telephone Number	:	513-389-5418

Provider Enumeration Date	:	04/16/2012
Last Update Date	:	04/16/2012

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Directions to “MERCY HEALTH PARTNERS ” Practice Location

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