Healthcare Provider Details

I. General information

NPI: 1720851504
Provider Name (Legal Business Name): MERCY HEALTH REGIONAL TRANSPORT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2023
Last Update Date: 03/21/2024
Certification Date: 03/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

708 W SPRING ST
LIMA OH
45801-4661
US

IV. Provider business mailing address

708 W SPRING ST
LIMA OH
45801-4661
US

V. Phone/Fax

Practice location:
  • Phone: 419-224-4075
  • Fax:
Mailing address:
  • Phone: 419-224-4075
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VII. Legacy identifiers

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

VIII. Authorized Official

Name: LORI RECKER
Title or Position: MANAGER PAYOR CREDENTIALING
Credential:
Phone: 419-871-6403