Healthcare Provider Details

I. General information

NPI: 1689801953
Provider Name (Legal Business Name): MOUNT CARMEL HOSPICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2009
Last Update Date: 06/15/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1144 DUBLIN RD
COLUMBUS OH
43215-1039
US

IV. Provider business mailing address

PO BOX 634341
CINCINNATI OH
45263-4341
US

V. Phone/Fax

Practice location:
  • Phone: 614-234-0200
  • Fax: 614-234-0201
Mailing address:
  • Phone: 614-546-3493
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: LORI YOSICK
Title or Position: INTERIM MANAGEMENT
Credential:
Phone: 614-234-0223