Healthcare Provider Details

I. General information

NPI: 1750532875
Provider Name (Legal Business Name): MOUNT CARMEL HEALTH PROVIDERS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2008
Last Update Date: 10/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6150 EAST BROAD STREET
COLUMBUS OH
43213
US

IV. Provider business mailing address

PO BOX 951603
CLEVELAND OH
44193-0018
US

V. Phone/Fax

Practice location:
  • Phone: 614-546-4345
  • Fax: 614-546-4427
Mailing address:
  • Phone: 614-546-4400
  • Fax: 614-546-4441

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: BRITTANY MOYER
Title or Position: IMPLEMENTATION SPECIALIST
Credential:
Phone: 614-546-4672