Provider Demographics
NPI:1073615456
Name:MOUNT CARMEL HEALTH SYSTEM
Entity Type:Organization
Organization Name:MOUNT CARMEL HEALTH SYSTEM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:PRIDAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-546-4146
Mailing Address - Street 1:3100 EASTON SQUARE PL
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43219-6289
Mailing Address - Country:US
Mailing Address - Phone:734-343-3320
Mailing Address - Fax:
Practice Address - Street 1:150 TAYLOR STATION RD STE 200
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43213-4470
Practice Address - Country:US
Practice Address - Phone:614-627-1305
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-05
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH261QS1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder DiagnosticGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHH430360Medicare PIN