MEDICARE: MOUNT CARMEL HEALTH SYSTEM

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	332B00000X	Durable Medical Equipment & Medical Supplies		OH
2	261QU0200X	Urgent Care Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	5621580001	OTHER	OH	DME
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1811975279
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOUNT CARMEL HEALTH SYSTEM

Provider Business Mailing Address
First Line	:	3100 EASTON SQUARE PL STE 300
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43219-6290
Country	:	US
Telephone Number	:	734-343-3320
Fax Number	:

Provider Business Practice Location Address
First Line	:	3000 MEADOW POND CT
Second Line	:	STE 200
City	:	GROVE CITY
State	:	OH
Zip	:	43123-9827
Country	:	US
Telephone Number	:	614-871-7130
Fax Number	:	614-277-2690

Authorized Official
Title or Position	:	CHIEF FINANCIAL OFFICER
Name	:	MR. ANDREW PRIDAY
Credential	:
Telephone Number	:	614-546-4146

Provider Enumeration Date	:	01/05/2006
Last Update Date	:	09/23/2022

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