Organization
MERCY HEALTH-REGIONAL MEDICAL CENTER LLC
Active
Other names
Mercy Health Lorain Outpatient Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY RALSTON (VP REIMBURSEMENT)
(419) 996-5119
Entity
Organization
Contact information
Practice address
3600 KOLBE RD STE 102, LORAIN, OH 44053-1652
(419) 555-5555
(440) 960-4509
Mailing address
PO BOX 636409, CINCINNATI, OH 45263-6409
(419) 555-5555
(844) 819-1196
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0002X
Clinic Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PMY.022819500-0
OH
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2175303
PK
—
Enumeration date
01/16/2018
Last updated
05/30/2025
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