Healthcare Provider Details

I. General information

NPI: 1295064467
Provider Name (Legal Business Name): MERCY HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2009
Last Update Date: 12/16/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4411 WASHINGTON AVE
EVANSVILLE IN
47714-0890
US

IV. Provider business mailing address

6140 E COLUMBIA ST
EVANSVILLE IN
47715-9133
US

V. Phone/Fax

Practice location:
  • Phone: 812-475-1948
  • Fax: 812-401-1267
Mailing address:
  • Phone: 812-475-1948
  • Fax: 812-401-1267

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: LOTFI HADAD
Title or Position: OWNER
Credential: M.D.
Phone: 812-475-1948