Healthcare Provider Details

I. General information

NPI: 1205988557
Provider Name (Legal Business Name): MERCY COMMUNITY SEVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/17/2007
Last Update Date: 03/31/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 WOODLAND HILLS BLVD
FORT SCOTT KS
66701-8797
US

IV. Provider business mailing address

401 WOODLAND HILLS BLVD
FORT SCOTT KS
66701-8797
US

V. Phone/Fax

Practice location:
  • Phone: 620-223-7075
  • Fax: 620-223-7050
Mailing address:
  • Phone: 620-223-7075
  • Fax: 620-223-7050

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number209814
License Number StateKS

VIII. Authorized Official

Name: JENNIFER DUNSHEE
Title or Position: PIC
Credential: RPH
Phone: 620-223-7075