NPIMap

Organization Active NPI

Mercy Health-Marcum & Wallace Hospital LLC

  • Community/Retail Pharmacy
  • Irvine, KY
National Provider Identifier
1427637321
Registry record updated Oct 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
MERCY HEALTH-MARCUM & WALLACE HOSPITAL LLC
Doing business as
Harness Health Pharmacy
Harness Health Pharmacy #220
Practice address
990 Richmond Rd
Irvine, KY 40336-7230
Phone
(606) 726-8270
NPI assigned
Apr 7, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2022

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

Authorized official

Name
Kimberly M Ralston
Title
System Director
Phone
(419) 996-5119

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

990 Richmond Rd
Irvine, KY 40336-7230

Mailing address

990 Richmond Rd
Irvine, KY 40336-7230
Phone (606) 726-8270

Other names 2

  • Harness Health Pharmacy Doing business as
  • Harness Health Pharmacy #220 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20230613002878 KY Part B Supplier - Mass Immunization (Roster Biller Only) 6901799386 Practice locations: Irvine, KY
O20240912000376 KY DME Supplier - Pharmacy 6901799386 Practice locations: Irvine, KY

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

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.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Mercy Health-Marcum & Wallace Hospi990 Richmond Rd, Irvine, KY 40336-7230(606) 726-8270 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs Accepts assignmentParticipating since Oct 24, 2016

National Provider Directory

National Provider Directory
Tax ID family
Bassem Adie MD5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

990 Richmond Rd
Irvine, KY 40336
Phone (606) 726-8217

60 Mercy Ct
Irvine, KY 40336
Phone (606) 723-2115

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Mercy Health - Irvine Primary CareIrvine, KY, CCN 183462 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jul 1, 2010
Mercy Health - Powell County Primary CareClay City, KY, CCN 183475 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Sep 1, 2012

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1617753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666569600000",
    "number": "1427637321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "990 RICHMOND RD",
            "city": "IRVINE",
            "state": "KY",
            "postal_code": "403367230",
            "telephone_number": "606-726-8270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "990 RICHMOND RD",
            "city": "IRVINE",
            "state": "KY",
            "postal_code": "403367230",
            "telephone_number": "606-726-8270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY HEALTH-MARCUM & WALLACE HOSPITAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-07",
        "last_updated": "2022-10-24",
        "certification_date": "2022-10-24",
        "status": "A",
        "authorized_official_last_name": "RALSTON",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "SYSTEM DIRECTOR",
        "authorized_official_telephone_number": "419-996-5119"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Harness Health Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Harness Health Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Harness Health Pharmacy #220",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Irvine, KY

Sources for this page

Verify at the official NPI Registry.