Healthcare Provider Details

I. General information

NPI: 1801825997
Provider Name (Legal Business Name): MERCY HEALTH-ALLEN HOSPITAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2006
Last Update Date: 06/20/2023
Certification Date: 06/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 W LORAIN ST
OBERLIN OH
44074-1026
US

IV. Provider business mailing address

PO BOX 636569
CINCINNATI OH
45263-6569
US

V. Phone/Fax

Practice location:
  • Phone: 440-960-3983
  • Fax: 440-960-3359
Mailing address:
  • Phone: 440-960-3983
  • Fax: 440-960-3359

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number
License Number State

VIII. Authorized Official

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