Provider Demographics
NPI:1770668568
Name:MOUNT CARMEL HEALTH SYSTEM
Entity Type:Organization
Organization Name:MOUNT CARMEL HEALTH SYSTEM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:PRIDAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-546-4146
Mailing Address - Street 1:3100 EASTON SQUARE PL STE 300
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43219-6290
Mailing Address - Country:US
Mailing Address - Phone:734-343-3320
Mailing Address - Fax:
Practice Address - Street 1:7333 SMITHS MILL RD
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:OH
Practice Address - Zip Code:43054-9291
Practice Address - Country:US
Practice Address - Phone:614-775-6600
Practice Address - Fax:614-775-5071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-27
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1451284300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes284300000XHospitalsSpecial Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
125376100OtherUS DEPARTMENT OF LABOR
000000312887OtherANTHEM
OH2458979Medicaid
OH41205300300OtherBUREAU OF WORKERS COMPENS
OH41205300300OtherBUREAU OF WORKERS COMPENS