Healthcare Provider Details

I. General information

NPI: 1437812948
Provider Name (Legal Business Name): MERCY HEALTH - ST VINCENT MEDICAL CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2021
Last Update Date: 09/25/2024
Certification Date: 09/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 NAVARRE AVE
OREGON OH
43616-3207
US

IV. Provider business mailing address

PO BOX 636447
CINCINNATI OH
45263-6447
US

V. Phone/Fax

Practice location:
  • Phone: 419-696-7200
  • Fax:
Mailing address:
  • Phone: 419-696-7200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273R00000X
TaxonomyPsychiatric Hospital Unit
License Number
License Number State

VIII. Authorized Official

Name: KIMBERLY M RALSTON
Title or Position: SYSTEM DIRECTOR
Credential:
Phone: 419-996-5119