Provider Demographics
NPI:1992132740
Name:MOUNT CARMEL HEALTHPROVIDERS, INC
Entity type:Organization
Organization Name:MOUNT CARMEL HEALTHPROVIDERS, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:HANCOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-546-4621
Mailing Address - Street 1:10330 SAWMILL PKWY
Mailing Address - Street 2:600
Mailing Address - City:POWELL
Mailing Address - State:OH
Mailing Address - Zip Code:43065-7790
Mailing Address - Country:US
Mailing Address - Phone:614-760-5959
Mailing Address - Fax:614-760-5959
Practice Address - Street 1:10330 SAWMILL PKWY
Practice Address - Street 2:600
Practice Address - City:POWELL
Practice Address - State:OH
Practice Address - Zip Code:43065-7790
Practice Address - Country:US
Practice Address - Phone:614-760-5959
Practice Address - Fax:614-760-5959
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-10
Last Update Date:2013-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty