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General NPI Number Information
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NPI Number | 1194855825
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Entity Type | Organization
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Legal Business Name | MERCY HEALTH YOUNGSTOWN LLC
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 01/26/2022
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Provider Practice Location Address
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Address Line | 667 EASTLAND AVE SE
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City | WARREN
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State | OH
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Zip | 44484-4503
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Country | US
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Telephone | 330-841-4096
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Fax | 330-841-4881
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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 | 330-841-4096
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Fax | 330-841-4881
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Authorized Official
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Title or Position | SYSTEM DIRECTOR
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Name | KIMBERLY 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 | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 021423750
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License Number State | OH
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