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NPI Code Detail

MEDICARE: MERCY HEALTH PHYSICIANS YOUNGSTOWN SPECIALTY CARE LLC

MEDICARE: MERCY HEALTH PHYSICIANS YOUNGSTOWN SPECIALTY CARE LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1332BC3200XCustomized Equipment (DME)

General Provider Information

NPI Number : 1407518749
Entity Type Code : Organization
Provider Name (Legal Business Name) : MERCY HEALTH PHYSICIANS YOUNGSTOWN SPECIALTY CARE LLC
Provider Business Mailing Address
First Line : PO BOX 631332
Second Line :
City : CINCINNATI
State : OH
Zip : 45263-1332
Country : US
Telephone Number : 888-696-3541
Fax Number : 513-952-6002
Provider Business Practice Location Address
First Line : 564 E 2ND ST
Second Line :
City : SALEM
State : OH
Zip : 44460-2914
Country : US
Telephone Number : 234-567-8150
Fax Number :
Authorized Official
Title or Position : CFO
Name : WILBUR GAY
Credential :
Telephone Number : 888-696-3541
Provider Enumeration Date : 10/13/2021
Last Update Date : 10/13/2021

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Directions to “MERCY HEALTH PHYSICIANS YOUNGSTOWN SPECIALTY CARE LLC ” Practice Location

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