Healthcare Provider Details

I. General information

NPI: 1487674297
Provider Name (Legal Business Name): MERCY HEALTH-ST RITAS MEDICAL CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 01/13/2022
Certification Date: 01/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 E 5TH ST
DELPHOS OH
45833-9139
US

IV. Provider business mailing address

PO BOX 951999
CLEVELAND OH
44193-0021
US

V. Phone/Fax

Practice location:
  • Phone: 419-692-2662
  • Fax: 419-996-5458
Mailing address:
  • Phone: 419-692-2662
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier2412811
Identifier TypeMEDICAID
Identifier StateOH
Identifier Issuer

VIII. Authorized Official

Name: MRS. KIMBERLY RALSTON
Title or Position: SYSTEM
Credential:
Phone: 419-996-5119