Healthcare Provider Details

I. General information

NPI: 1396877106
Provider Name (Legal Business Name): MOUNT CARMEL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

745 W STATE ST
COLUMBUS OH
43222-1515
US

IV. Provider business mailing address

211 W JOHNSTOWN RD
GAHANNA OH
43230-2732
US

V. Phone/Fax

Practice location:
  • Phone: 614-234-5447
  • Fax: 614-234-2878
Mailing address:
  • Phone: 614-337-7031
  • Fax: 614-337-7027

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: MRS. LISA BREWSTER
Title or Position: BILLING MANAGER
Credential:
Phone: 614-337-7031