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General NPI Number Information
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NPI Number | 1194495150
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Entity Type | Organization
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Legal Business Name | MERCY HEALTH - ST ANNE HOSPITAL LLC
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Dates
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Enumeration Date | 09/20/2021
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Last Update Date | 01/13/2022
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Provider Practice Location Address
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Address Line | 12623 ECKEL JUNCTION RD
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City | PERRYSBURG
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State | OH
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Zip | 43551-1304
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Country | US
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Telephone | 567-368-1434
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 639922
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City | CINCINNATI
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State | OH
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Zip | 45263-9922
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SYSTEM DIRECTOR PAYOR ADMIN
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Name | KIMBERLY M RALSTON
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Credential |
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Telephone | 419-996-5119
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0002X
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Taxonomy Name | Clinic Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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