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General NPI Number Information
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NPI Number | 1477062289
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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 | 09/25/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 8401 MARKET ST
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City | BOARDMAN
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State | OH
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Zip | 44512-6725
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Country | US
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Telephone | 513-952-5063
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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 | 513-952-5063
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Fax |
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Authorized Official
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Title or Position | SYSTEM DIRECTO
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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 | 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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