Healthcare Provider Details

I. General information

NPI: 1790609618
Provider Name (Legal Business Name): MERCY HEALTH - CLERMONT HOSPITAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

621 W MAIN ST
MOUNT ORAB OH
45154-8265
US

IV. Provider business mailing address

621 W MAIN ST
MOUNT ORAB OH
45154-8265
US

V. Phone/Fax

Practice location:
  • Phone: 937-444-0952
  • Fax:
Mailing address:
  • Phone: 937-444-0952
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KIMBERLY M RALSTON
Title or Position: VP REIMBURSEMENT
Credential:
Phone: 419-996-5119