Healthcare Provider Details

I. General information

NPI: 1750349932
Provider Name (Legal Business Name): MERCY MEDICAL SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2006
Last Update Date: 03/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7301 ROGERS AVE
FORT SMITH AR
72903-4100
US

IV. Provider business mailing address

PO BOX 17000
FORT SMITH AR
72917-7000
US

V. Phone/Fax

Practice location:
  • Phone: 479-314-6100
  • Fax: 479-314-1770
Mailing address:
  • Phone: 479-314-6100
  • Fax: 479-314-1770

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. GRETA WILCHER
Title or Position: SENIOR VICE PRESIDENT/CFO
Credential:
Phone: 479-314-6100