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General NPI Number Information
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NPI Number | 1700214558
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Entity Type | Organization
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Legal Business Name | MERCY HEALTH-LOURDES HOSPITAL LLC
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Dates
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Enumeration Date | 10/14/2013
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Last Update Date | 11/01/2023
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Provider Practice Location Address
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Address Line | 225 MEDICAL CENTER DR STE 100
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City | PADUCAH
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State | KY
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Zip | 42003-7934
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Country | US
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Telephone | 270-444-2233
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Fax | 270-444-2388
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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 | 270-444-2233
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Fax | 270-444-2388
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Authorized Official
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Title or Position | VP REIMBURSEMENT
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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 | 3336C0004X
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Taxonomy Name | Compounding 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 | 3336H0001X
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Taxonomy Name | Home Infusion Therapy 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 | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | P06795
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License Number State | KY
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