Provider Demographics
NPI:1124056874
Name:MERCY HEALTH-REGIONAL MEDICAL CENTER LLC
Entity type:Organization
Organization Name:MERCY HEALTH-REGIONAL MEDICAL CENTER LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWIN
Authorized Official - Middle Name:M
Authorized Official - Last Name:OLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-960-3295
Mailing Address - Street 1:3500 KOLBE RD
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44053-1632
Mailing Address - Country:US
Mailing Address - Phone:440-934-1458
Mailing Address - Fax:440-960-3359
Practice Address - Street 1:3500 KOLBE RD
Practice Address - Street 2:
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44053-1632
Practice Address - Country:US
Practice Address - Phone:440-934-1458
Practice Address - Fax:440-960-3359
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MERCY HEALTH LORAIN LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-30
Last Update Date:2019-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
No315D00000XNursing & Custodial Care FacilitiesHospice, Inpatient
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2412197Medicaid
OH2412197Medicaid