Provider Demographics
NPI:1013942630
Name:MOUNT CARMEL HEALTH PROVIDERS III LLC
Entity Type:Organization
Organization Name:MOUNT CARMEL HEALTH PROVIDERS III LLC
Other - Org Name:MOUNT CARMEL HEALTH STATIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:REGIONAL DIRECTOR, REV CYCLE OPS
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-546-3738
Mailing Address - Street 1:6150 E BROAD ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43213-1574
Mailing Address - Country:US
Mailing Address - Phone:614-546-4400
Mailing Address - Fax:614-546-4441
Practice Address - Street 1:6150 E BROAD ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43213-1574
Practice Address - Country:US
Practice Address - Phone:614-546-4400
Practice Address - Fax:614-546-4441
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-12
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9362671Medicare PIN