Provider Demographics
NPI:1548296106
Name:MERCY HEALTH YOUNGSTOWN LLC
Entity type:Organization
Organization Name:MERCY HEALTH YOUNGSTOWN LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO YOUNGSTOWN
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:SEMINARO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-480-6063
Mailing Address - Street 1:PO BOX 636469
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-6469
Mailing Address - Country:US
Mailing Address - Phone:330-746-7211
Mailing Address - Fax:
Practice Address - Street 1:1044 BELMONT AVE
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44504-1006
Practice Address - Country:US
Practice Address - Phone:330-746-7211
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-24
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
273R00000X, 282N00000X
OH3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No273R00000XHospital UnitsPsychiatric Unit
No3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH02-091520OtherPHARMACY
OH07-M-01230-01OtherRADIOLOGY
OH366075600OtherUS DEPT OF LABOR
OH7645338Medicaid
OH000000067490OtherUNISON
OH000000156990OtherANTHEM
OH000000155281OtherANTHEM
OH3500220OtherUHC
36D0656161OtherCLIA - CMS
OH6461190OtherAETNA
OH000000156988OtherANTHEM
OH1007751650002OtherMAPA
OH1513787OtherGATEWAY-OH
OH5000068OtherUHC
OH1007751650002OtherMAPA
OH000000067490OtherUNISON
OH5000068OtherUHC
OH07-M-01230-01OtherRADIOLOGY
OH366075600OtherUS DEPT OF LABOR
OH=========OtherSUMMACARE