Provider Demographics
NPI:1245789981
Name:MERCY HEALTH - ANDERSON HOSPITAL LLC
Entity Type:Organization
Organization Name:MERCY HEALTH - ANDERSON HOSPITAL LLC
Other - Org Name:ANDERSON HOSPITAL - REHAB UNIT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT MERCY HEALTH ANDERSON
Authorized Official - Prefix:MR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:JAMES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-732-8590
Mailing Address - Street 1:PO BOX 635915
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-5915
Mailing Address - Country:US
Mailing Address - Phone:513-624-4500
Mailing Address - Fax:513-981-5728
Practice Address - Street 1:7500 STATE RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45255-2439
Practice Address - Country:US
Practice Address - Phone:513-624-4500
Practice Address - Fax:513-981-5728
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-22
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH273Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH6639409Medicaid