Healthcare Provider Details

I. General information

NPI: 1124056874
Provider Name (Legal Business Name): MERCY HEALTH-REGIONAL MEDICAL CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2006
Last Update Date: 04/15/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3500 KOLBE RD
LORAIN OH
44053-1632
US

IV. Provider business mailing address

3500 KOLBE RD
LORAIN OH
44053-1632
US

V. Phone/Fax

Practice location:
  • Phone: 440-934-1458
  • Fax: 440-960-3359
Mailing address:
  • Phone: 440-934-1458
  • Fax: 440-960-3359

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code315D00000X
TaxonomyInpatient Hospice
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. EDWIN M. OLEY
Title or Position: PRESIDENT & CEO
Credential:
Phone: 440-960-3295