Provider Demographics
NPI:1811975279
Name:MOUNT CARMEL HEALTH SYSTEM
Entity type:Organization
Organization Name:MOUNT CARMEL HEALTH SYSTEM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:PRIDAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-546-4146
Mailing Address - Street 1:3100 EASTON SQUARE PL STE 300
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43219-6290
Mailing Address - Country:US
Mailing Address - Phone:734-343-3320
Mailing Address - Fax:
Practice Address - Street 1:3000 MEADOW POND CT
Practice Address - Street 2:STE 200
Practice Address - City:GROVE CITY
Practice Address - State:OH
Practice Address - Zip Code:43123-9827
Practice Address - Country:US
Practice Address - Phone:614-871-7130
Practice Address - Fax:614-277-2690
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-05
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH332B00000X
261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH5621580001OtherDME
OH0099836Medicaid
OH9308562Medicare PIN