Healthcare Provider Details

I. General information

NPI: 1265199574
Provider Name (Legal Business Name): MERCY HEALTH - CLERMONT HOSPITAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/22/2021
Last Update Date: 01/26/2022
Certification Date: 01/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 HOSPITAL DR
BATAVIA OH
45103-1921
US

IV. Provider business mailing address

PO BOX 635804
CINCINNATI OH
45263-5804
US

V. Phone/Fax

Practice location:
  • Phone: 513-732-8200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KIMBERLY M RALSTON
Title or Position: SYSTEM DIR
Credential:
Phone: 419-996-5119