Provider Demographics
NPI:1053706903
Name:MERCY HEALTH - ST ANNE HOSPITAL LLC
Entity type:Organization
Organization Name:MERCY HEALTH - ST ANNE HOSPITAL LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:BERTKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-407-2400
Mailing Address - Street 1:3404 W SYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43623-4467
Mailing Address - Country:US
Mailing Address - Phone:419-407-2400
Mailing Address - Fax:
Practice Address - Street 1:2000 REGENCY CT
Practice Address - Street 2:SUITE 101
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43623-3090
Practice Address - Country:US
Practice Address - Phone:419-882-0003
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MERCY HEALTH NORTH, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-03-30
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical