Healthcare Provider Details

I. General information

NPI: 1619903143
Provider Name (Legal Business Name): MERCY HEALTH - ST VINCENT MEDICAL CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2006
Last Update Date: 01/25/2022
Certification Date: 01/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 JEFFERSON AVE
TOLEDO OH
43624-1120
US

IV. Provider business mailing address

2200 JEFFERSON AVE 4TH FL
TOLEDO OH
43624-1120
US

V. Phone/Fax

Practice location:
  • Phone: 419-251-1400
  • Fax: 419-251-1797
Mailing address:
  • Phone: 419-251-8997
  • Fax: 419-251-3553

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: SAMATHA PLATZKE
Title or Position: CFO
Credential:
Phone: 419-251-2046