Provider Demographics
NPI:1972689123
Name:MERCY HEALTH - WEST HOSPITAL LLC
Entity Type:Organization
Organization Name:MERCY HEALTH - WEST HOSPITAL LLC
Other - Org Name:MERCY FRANCISCAN HOSPITAL - MT. AIRY (LONG TERM CARE NURSING UNIT)
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:C
Authorized Official - Last Name:HILTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-853-5925
Mailing Address - Street 1:4600 MCAULEY PL
Mailing Address - Street 2:5TH FLOOR - FINANCE
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45242-4733
Mailing Address - Country:US
Mailing Address - Phone:513-981-6696
Mailing Address - Fax:513-981-6117
Practice Address - Street 1:2446 KIPLING AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45239-6650
Practice Address - Country:US
Practice Address - Phone:513-853-5900
Practice Address - Fax:513-853-5910
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-31
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0171362Medicaid
OH365959Medicare ID - Type Unspecified