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NPI Code Detail

MEDICARE: MERCY CATHOLIC MEDICAL CENTER OF SOUTHEASTERN PA

MEDICARE: MERCY CATHOLIC MEDICAL CENTER OF SOUTHEASTERN PA
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
12084P0800XPsychiatry Physician
2207R00000XInternal Medicine Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1025024OTHERPAHEALTHPARTNERS
230001873OTHERPAKMHP
3G0006731OTHERPAAMERICHOICE
4372921OTHERPAHIGHMARK BLUE SHIELD
50114720000OTHERPAKHPE
6G0007408OTHERPAAMERICHOICE

General Provider Information

NPI Number : 1437130705
Entity Type Code : Organization
Provider Name (Legal Business Name) : MERCY CATHOLIC MEDICAL CENTER OF SOUTHEASTERN PA
Provider Business Mailing Address
First Line : 1 W ELM ST
Second Line : SUITE 100
City : CONSHOHOCKEN
State : PA
Zip : 19428-4108
Country : US
Telephone Number : 610-567-6967
Fax Number : 610-567-6170
Provider Business Practice Location Address
First Line : 1503 LANSDOWNE AVENUE
Second Line : SUITE 2000
City : PHILADELPHIA
State : PA
Zip : 19143-1900
Country : US
Telephone Number : 610-237-3646
Fax Number : 610-237-4261
Authorized Official
Title or Position : V.P. FINANCE
Name : PHYLLIS HILKER
Credential :
Telephone Number : 610-567-6967
Provider Enumeration Date : 11/14/2005
Last Update Date : 01/30/2018

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Directions to “MERCY CATHOLIC MEDICAL CENTER OF SOUTHEASTERN PA ” Practice Location

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