Provider Demographics
NPI:1669504387
Name:MOUNT CARMEL HEALTH SYSTEM
Entity type:Organization
Organization Name:MOUNT CARMEL HEALTH SYSTEM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, EMPLOYER SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:TARA
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-546-4365
Mailing Address - Street 1:6150 E BROAD ST
Mailing Address - Street 2:2ND FLOOR, EB 239B
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43213-1574
Mailing Address - Country:US
Mailing Address - Phone:614-546-4621
Mailing Address - Fax:614-546-4536
Practice Address - Street 1:5969 E BROAD ST
Practice Address - Street 2:301
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43213-1539
Practice Address - Country:US
Practice Address - Phone:614-234-7090
Practice Address - Fax:614-234-7901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2017-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational MedicineGroup - Multi-Specialty