Healthcare Provider Details

I. General information

NPI: 1700214558
Provider Name (Legal Business Name): MERCY HEALTH-LOURDES HOSPITAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2013
Last Update Date: 05/30/2026
Certification Date: 05/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 MEDICAL CENTER DR STE 100
PADUCAH KY
42003-7934
US

IV. Provider business mailing address

PO BOX 639922
CINCINNATI OH
45263-9922
US

V. Phone/Fax

Practice location:
  • Phone: 270-444-2233
  • Fax: 270-444-2388
Mailing address:
  • Phone: 270-444-2233
  • Fax: 270-444-2388

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberP06795
License Number StateKY

VIII. Authorized Official

Name: KIMBERLY RALSTON
Title or Position: VP REIMBURSEMENT
Credential:
Phone: 419-996-5119