NPIMap

Organization Active NPI

Mercy Health Youngstown LLC

Doing business as St Elizabeth H C Clinic

  • Durable Medical Equipment & Medical Supplies
  • Youngstown, OH
National Provider Identifier
1083700058
Registry record updated Jan 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
MERCY HEALTH YOUNGSTOWN LLC
Doing business as
St Elizabeth H C Clinic
Practice address
1044 Belmont Ave
Youngstown, OH 44501
Phone
(330) 480-8610
Fax
(330) 480-1469
NPI assigned
Oct 5, 2006
Last updated
Jan 26, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Barry H Shick, RPH
Title
Administrative Director Pharmacy SE
Phone
(330) 480-2587

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary
Pharmacist 183500000X

Addresses

Primary practice location

1044 Belmont Ave
Youngstown, OH 44501

Mailing address

1044 Belmont Ave
Youngstown, OH 44501
Phone (330) 480-8610

Other identifiers 1

IdentifierTypeStateIssuer
9645228MedicaidOH

Other names 1

  • St Elizabeth H C Clinic Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D2121709Mercy Health Youngstown1044 Belmont Avenue, Youngstown, OH 44501Certificate of waiverNov 13, 2026

National Provider Directory

National Provider Directory
Tax ID family
HM Health Services SE28 organizations share this tax ID, including this one

Other organizations with this tax ID 27

Organizations that report the same tax identification number in the National Provider Directory.

View all 27

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643155200000",
    "number": "1083700058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1044 BELMONT AVE",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "44501",
            "telephone_number": "330-480-8610",
            "fax_number": "330-480-1469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1044 BELMONT AVE",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "44501",
            "telephone_number": "330-480-8610",
            "fax_number": "330-480-1469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY HEALTH YOUNGSTOWN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-05",
        "last_updated": "2022-01-26",
        "certification_date": "2022-01-26",
        "status": "A",
        "authorized_official_last_name": "SHICK",
        "authorized_official_first_name": "BARRY",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "ADMINISTRATIVE DIRECTOR PHARMACY SE",
        "authorized_official_telephone_number": "330-480-2587",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9645228",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St Elizabeth H C Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "St Elizabeth H C Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Youngstown, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.