Provider Demographics
NPI:1689801953
Name:MOUNT CARMEL HOSPICE
Entity Type:Organization
Organization Name:MOUNT CARMEL HOSPICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTERIM MANAGEMENT
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:YOSICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-234-0223
Mailing Address - Street 1:PO BOX 634341
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-4341
Mailing Address - Country:US
Mailing Address - Phone:614-546-3493
Mailing Address - Fax:
Practice Address - Street 1:1144 DUBLIN RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-1039
Practice Address - Country:US
Practice Address - Phone:614-234-0200
Practice Address - Fax:614-234-0201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-15
Last Update Date:2009-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH361520Medicare PIN