Healthcare Provider Details

I. General information

NPI: 1376997551
Provider Name (Legal Business Name): MERCY MEMORIAL HOSPITAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2016
Last Update Date: 12/22/2023
Certification Date: 12/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 STEWART RD
MONROE MI
48162-4226
US

IV. Provider business mailing address

800 STEWART RD
MONROE MI
48162-4226
US

V. Phone/Fax

Practice location:
  • Phone: 734-240-1800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: KEVIN SHARP
Title or Position: VICE PRESIDENT, REVENUE CYCLE
Credential:
Phone: 567-585-7576