# MOUNT CARMEL HEALTHPROVIDERS III, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Mount Carmel Health Stations Reynoldsburg
- **Organization subpart:** No

## Provider details

- **NPI number:** 1659646628
- **Authorized official:** DIANA HANCOCK (CREDENTIALING COORDINATOR)
- **Authorized official phone:** (614) 546-4621

## Contact information

- **Practice address:** 6699 E LIVINGSTON AVE, REYNOLDSBURG, OH 43068-3688
- **Practice address phone:** (614) 367-1255
- **Practice address fax:** (614) 367-1265
- **Mailing address:** 6699 E LIVINGSTON AVE, REYNOLDSBURG, OH 43068-3688
- **Mailing address phone:** (614) 367-1255
- **Mailing address fax:** (614) 367-1265

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/09/2012
- **Last updated:** 03/09/2012