Provider Demographics
NPI:1255009601
Name:MERCY HEALTH PHYSICIANS YOUNGSTOWN SPECIALTY CARE LLC
Entity Type:Organization
Organization Name:MERCY HEALTH PHYSICIANS YOUNGSTOWN SPECIALTY CARE LLC
Other - Org Name:MHPY SPC - HOWLAND IMAGING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO, MEDICAL GROUP
Authorized Official - Prefix:
Authorized Official - First Name:WILBUR
Authorized Official - Middle Name:
Authorized Official - Last Name:GAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-255-1904
Mailing Address - Street 1:1932 NILES CORTLAND RD NE
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44484-1055
Mailing Address - Country:US
Mailing Address - Phone:330-306-5300
Mailing Address - Fax:
Practice Address - Street 1:1932 NILES CORTLAND RD NE
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44484-1055
Practice Address - Country:US
Practice Address - Phone:330-306-5300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-01
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
No2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Multi-Specialty