Provider Demographics
NPI:1780452227
Name:MERCY HEALTH PHYSICIANS CINCINNATI SPECIALTY CARE LLC
Entity type:Organization
Organization Name:MERCY HEALTH PHYSICIANS CINCINNATI SPECIALTY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DELEGATED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:CASSIE
Authorized Official - Middle Name:
Authorized Official - Last Name:LOWE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-952-5210
Mailing Address - Street 1:5470 KINGS ISLAND DR
Mailing Address - Street 2:SUITE 120
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040
Mailing Address - Country:US
Mailing Address - Phone:513-347-9999
Mailing Address - Fax:513-874-3023
Practice Address - Street 1:5470 KINGS ISLAND DR
Practice Address - Street 2:SUITE 120
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040
Practice Address - Country:US
Practice Address - Phone:513-347-9999
Practice Address - Fax:513-874-3023
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-14
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies