Healthcare Provider Details

I. General information

NPI: 1679513386
Provider Name (Legal Business Name): MERCY HEALTH - WILLARD HOSPITAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 01/31/2022
Certification Date: 01/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 E HOWARD ST
WILLARD OH
44890-1611
US

IV. Provider business mailing address

110 E HOWARD ST
WILLARD OH
44890-1611
US

V. Phone/Fax

Practice location:
  • Phone: 419-964-5000
  • Fax:
Mailing address:
  • Phone: 419-964-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. STEVEN L MICKUS
Title or Position: PRESIDENT & CEO
Credential:
Phone: 419-251-8944