MEDICARE: MERCY HOSPITAL SPRINGFIELD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1437102365
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MERCY HOSPITAL SPRINGFIELD

Provider Business Mailing Address
First Line	:	1570 W BATTLEFIELD ST
Second Line	:	SUITE 110
City	:	SPRINGFIELD
State	:	MO
Zip	:	65807-4163
Country	:	US
Telephone Number	:	417-820-5550
Fax Number	:	417-820-5551

Provider Business Practice Location Address
First Line	:	146 PASSION PLAY RD STE C
Second Line	:
City	:	EUREKA SPRINGS
State	:	AR
Zip	:	72632-9455
Country	:	US
Telephone Number	:	479-363-9244
Fax Number	:	479-363-9245

Authorized Official
Title or Position	:	VICE PRESIDENT FINANCE
Name	:	SCOTT R REYNOLDS
Credential	:
Telephone Number	:	417-820-2818

Provider Enumeration Date	:	05/19/2006
Last Update Date	:	02/13/2012

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