Healthcare Provider Details

I. General information

NPI: 1730918277
Provider Name (Legal Business Name): MERCY MEDICAL HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2024
Last Update Date: 08/01/2024
Certification Date: 08/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 FACTORY OUTLET DR
ARCADIA LA
71001-3057
US

IV. Provider business mailing address

PO BOX 70
HODGE LA
71247-0070
US

V. Phone/Fax

Practice location:
  • Phone: 318-475-3500
  • Fax:
Mailing address:
  • Phone: 318-475-3500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: CHRISTI A. PERMENTER
Title or Position: PHARMACY MANAGER
Credential:
Phone: 318-475-3500