Healthcare Provider Details

I. General information

NPI: 1043126121
Provider Name (Legal Business Name): MERCY HEALTH YOUNGSTOWN LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

564 E 2ND ST
SALEM OH
44460-2914
US

IV. Provider business mailing address

PO BOX 636469
CINCINNATI OH
45263-6469
US

V. Phone/Fax

Practice location:
  • Phone: 234-567-8150
  • Fax:
Mailing address:
  • Phone:
  • 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 REIMBURSMENT
Credential:
Phone: 419-996-5119