Provider Demographics
NPI:1285681841
Name:ROH LLC
Entity Type:Organization
Organization Name:ROH LLC
Other - Org Name:MERIT HEALTH WOMEN'S HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR/DELEGATED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:
Authorized Official - Last Name:LALOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:629-215-3953
Mailing Address - Street 1:1026 N FLOWOOD DR
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39232-9532
Mailing Address - Country:US
Mailing Address - Phone:601-933-6401
Mailing Address - Fax:601-936-3086
Practice Address - Street 1:1026 N FLOWOOD DR
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39232-9532
Practice Address - Country:US
Practice Address - Phone:601-933-6401
Practice Address - Fax:601-396-3086
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-28
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS12300282NW0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NW0100XHospitalsGeneral Acute Care HospitalWomen
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS0220466Medicaid
MS000020225OtherBLUE CROSS
MS0220466Medicaid