Healthcare Provider Details

I. General information

NPI: 1477162972
Provider Name (Legal Business Name): MERCY MEDICAL HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2020
Last Update Date: 07/19/2022
Certification Date: 07/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

244 BOND ST
JONESBORO LA
71251-5334
US

IV. Provider business mailing address

PO BOX 70
HODGE LA
71247-0070
US

V. Phone/Fax

Practice location:
  • Phone: 318-475-3500
  • Fax: 318-475-3502
Mailing address:
  • Phone: 318-259-1100
  • Fax: 318-259-1333

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State

VIII. Authorized Official

Name: KIMBERLY G. BRUNSON
Title or Position: CEO
Credential:
Phone: 318-259-1100