Provider Demographics
NPI:1790868982
Name:MERCY HEALTH YOUNGSTOWN LLC
Entity Type:Organization
Organization Name:MERCY HEALTH YOUNGSTOWN LLC
Other - Org Name:ST ELIZABETH BOARDMAN HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SYSTEM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:M
Authorized Official - Last Name:RALSTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-996-5119
Mailing Address - Street 1:PO BOX 636469
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-6469
Mailing Address - Country:US
Mailing Address - Phone:330-729-2929
Mailing Address - Fax:330-729-1563
Practice Address - Street 1:8401 MARKET ST
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44512-6777
Practice Address - Country:US
Practice Address - Phone:330-729-2929
Practice Address - Fax:330-729-1563
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital