Healthcare Provider Details
I. General information
NPI: 1730571100
Provider Name (Legal Business Name): MERCY HEALTH PARTNERS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/23/2015
Last Update Date: 11/05/2024
Certification Date: 11/05/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6401 PRAIRIE ST SUITE 2900
NORTON SHORES MI
49444-7840
US
IV. Provider business mailing address
6401 PRAIRIE ST STE 2900
NORTON SHORES MI
49444-7841
US
V. Phone/Fax
- Phone: 231-672-7890
- Fax: 231-672-7866
- Phone: 231-672-7890
- Fax: 231-672-7866
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | MI |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 335E00000X |
| Taxonomy | Prosthetic/Orthotic Supplier |
| License Number | |
| License Number State | MI |
VIII. Authorized Official
Name:
GARY
EDWARD
ALLORE
Title or Position: PRESIDENT
Credential:
Phone: 231-672-4888