Provider Demographics
NPI:1720255730
Name:MOUNT CARMEL HEALTH PROVIDERS INC
Entity Type:Organization
Organization Name:MOUNT CARMEL HEALTH PROVIDERS INC
Other - Org Name:BIG RUN INTERNAL MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:C
Authorized Official - Last Name:SCHUTTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-546-4424
Mailing Address - Street 1:4310 CLIME RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43228-3496
Mailing Address - Country:US
Mailing Address - Phone:614-274-7799
Mailing Address - Fax:614-274-3209
Practice Address - Street 1:4310 CLIME RD
Practice Address - Street 2:SUITE B
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43228-3496
Practice Address - Country:US
Practice Address - Phone:614-274-7799
Practice Address - Fax:614-274-3209
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-09
Last Update Date:2008-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9264991Medicare PIN