Provider Demographics
NPI:1942207287
Name:FILLING MEMORIAL HOME OF MERCY, INC.
Entity type:Organization
Organization Name:FILLING MEMORIAL HOME OF MERCY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:E
Authorized Official - Last Name:OEHRTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-592-6451
Mailing Address - Street 1:N160 STATE ROUTE 108
Mailing Address - Street 2:
Mailing Address - City:NAPOLEON
Mailing Address - State:OH
Mailing Address - Zip Code:43545-7729
Mailing Address - Country:US
Mailing Address - Phone:419-592-6451
Mailing Address - Fax:419-599-5178
Practice Address - Street 1:N160 STATE ROUTE 108
Practice Address - Street 2:
Practice Address - City:NAPOLEON
Practice Address - State:OH
Practice Address - Zip Code:43545-7729
Practice Address - Country:US
Practice Address - Phone:419-592-6451
Practice Address - Fax:419-599-5178
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH12966315P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0159868Medicaid
OH36-G026Medicare ID - Type Unspecified