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NPI Code Detail

MEDICARE: MERCY HEALTH - ST VINCENT MEDICAL CENTER LLC

MEDICARE: MERCY HEALTH - ST VINCENT MEDICAL CENTER 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
1207V00000XObstetrics & Gynecology Physician
2208000000XPediatrics Physician
3207R00000XInternal Medicine Physician

General Provider Information

NPI Number : 1558397018
Entity Type Code : Organization
Provider Name (Legal Business Name) : MERCY HEALTH - ST VINCENT MEDICAL CENTER LLC
Provider Business Mailing Address
First Line : PO BOX 1079
Second Line :
City : TOLEDO
State : OH
Zip : 43697-1079
Country : US
Telephone Number : 419-251-8997
Fax Number : 419-251-3553
Provider Business Practice Location Address
First Line : 2213 FRANKLIN AVE
Second Line :
City : TOLEDO
State : OH
Zip : 43620-1402
Country : US
Telephone Number : 419-251-2360
Fax Number :
Authorized Official
Title or Position : CFO
Name : SAMANTHA PLATZKE
Credential :
Telephone Number : 419-251-2046
Provider Enumeration Date : 06/24/2006
Last Update Date : 01/25/2022

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