Provider Demographics
NPI:1285671073
Name:MOUNT CARMEL CARE CONTINUUM SERVICE CORPORATION
Entity Type:Organization
Organization Name:MOUNT CARMEL CARE CONTINUUM SERVICE CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SR. VICE PRESIDENT & CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:A
Authorized Official - Last Name:PRIMEAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-546-4301
Mailing Address - Street 1:1165 DUBLIN RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43215-1005
Mailing Address - Country:US
Mailing Address - Phone:614-234-0300
Mailing Address - Fax:614-234-0306
Practice Address - Street 1:1165 DUBLIN RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-1005
Practice Address - Country:US
Practice Address - Phone:614-234-0300
Practice Address - Fax:614-234-0306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-01
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH250079341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH760485Medicaid
MT9233291Medicare ID - Type Unspecified