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General NPI Number Information
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NPI Number | 1659803740
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Entity Type | Organization
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Legal Business Name | COMMUNITY MERCY HEALTH PARTNERS
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Dates
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Enumeration Date | 03/29/2017
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Last Update Date | 06/16/2020
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Provider Practice Location Address
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Address Line | 100 MEDICAL CENTER DR
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City | SPRINGFIELD
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State | OH
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Zip | 45504-2687
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Country | US
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Telephone | 937-523-6000
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Fax | 937-523-6005
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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 | 937-523-6000
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Fax | 937-523-6005
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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 |
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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 | PMY.022696850-0
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License Number State | OH
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