Provider Demographics
NPI:1932124823
Name:MOUNT CARMEL CARE CONTINUUM
Entity Type:Organization
Organization Name:MOUNT CARMEL CARE CONTINUUM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:A
Authorized Official - Last Name:PRIMEAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-546-4300
Mailing Address - Street 1:4473 PROFESSIONAL PKWY
Mailing Address - Street 2:
Mailing Address - City:GROVEPORT
Mailing Address - State:OH
Mailing Address - Zip Code:43125-9229
Mailing Address - Country:US
Mailing Address - Phone:614-234-0034
Mailing Address - Fax:614-234-0560
Practice Address - Street 1:4473 PROFESSIONAL PKWY
Practice Address - Street 2:
Practice Address - City:GROVEPORT
Practice Address - State:OH
Practice Address - Zip Code:43125-9229
Practice Address - Country:US
Practice Address - Phone:614-234-0034
Practice Address - Fax:614-234-0560
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0492170001Medicare NSC