Provider Demographics
NPI:1134330608
Name:MERCY HEALTH - WEST HOSPITAL LLC
Entity Type:Organization
Organization Name:MERCY HEALTH - WEST HOSPITAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PHARMACY
Authorized Official - Prefix:
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:
Authorized Official - Last Name:HEENAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-389-5244
Mailing Address - Street 1:3131 QUEEN CITY AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45238-2316
Mailing Address - Country:US
Mailing Address - Phone:513-389-5244
Mailing Address - Fax:
Practice Address - Street 1:3131 QUEEN CITY AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45238-2316
Practice Address - Country:US
Practice Address - Phone:513-389-5244
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-25
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH02-0041150282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital