Provider Demographics
NPI:1861640963
Name:MOUNT CARMEL HEALTH PROVIDERS TWO LLC
Entity Type:Organization
Organization Name:MOUNT CARMEL HEALTH PROVIDERS TWO LLC
Other - Org Name:HEARTLAND CARDIOLOGY OF MOUNT CARMEL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:IMPLEMENTATION SPECIALISTS
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRITTANY
Authorized Official - Middle Name:N
Authorized Official - Last Name:MOYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-546-4672
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 1:5677 SCIOTO DARBY RD
Practice Address - Street 2:SUITE 100
Practice Address - City:HILLIARD
Practice Address - State:OH
Practice Address - Zip Code:43026-1391
Practice Address - Country:US
Practice Address - Phone:614-529-8185
Practice Address - Fax:614-443-8090
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MOUNT CARMEL HEALTH PROVIDERS TWO LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-09-03
Last Update Date:2008-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34005271207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty