Provider Demographics
NPI:1558596262
Name:MOUNT CARMEL HEALTH PROVIDERS TWO, LLC
Entity Type:Organization
Organization Name:MOUNT CARMEL HEALTH PROVIDERS TWO, LLC
Other - Org Name:VASCULAR SERVICES OF OHIO (CIRCLEVILLE)
Other - Org Type:Doing Business As
Authorized Official - Title/Position:IMPLEMENTATION SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:BRITTANY
Authorized Official - Middle Name:N
Authorized Official - Last Name:MOYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-546-4400
Mailing Address - Street 1:PO BOX 951144
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44193-0005
Mailing Address - Country:US
Mailing Address - Phone:614-546-4400
Mailing Address - Fax:614-546-4441
Practice Address - Street 1:142 MORRIS RD
Practice Address - Street 2:
Practice Address - City:CIRCLEVILLE
Practice Address - State:OH
Practice Address - Zip Code:43113-1362
Practice Address - Country:US
Practice Address - Phone:614-234-0444
Practice Address - Fax:614-234-0456
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-26
Last Update Date:2009-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty