Healthcare Provider Details

I. General information

NPI: 1790706901
Provider Name (Legal Business Name): ST MARY MERCY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2006
Last Update Date: 06/09/2025
Certification Date: 06/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36475 5 MILE RD
LIVONIA MI
48154-1971
US

IV. Provider business mailing address

36475 5 MILE RD
LIVONIA MI
48154-1971
US

V. Phone/Fax

Practice location:
  • Phone: 734-655-4800
  • Fax: 734-655-1274
Mailing address:
  • Phone: 734-655-4800
  • Fax: 734-655-1274

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number820190
License Number StateMI

VIII. Authorized Official

Name: MICHAEL P GUSHO
Title or Position: SEMI REGIONAL CFO
Credential:
Phone: 248-858-6174