Healthcare Provider Details

I. General information

NPI: 1861506727
Provider Name (Legal Business Name): MERCY HOSPITALS EAST COMMUNITIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2006
Last Update Date: 12/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12120 CONWAY ROAD
SAINT LOUIS MO
63141-8213
US

IV. Provider business mailing address

12120 CONWAY ROAD
SAINT LOUIS MO
63141-8213
US

V. Phone/Fax

Practice location:
  • Phone: 314-251-6600
  • Fax:
Mailing address:
  • Phone: 314-251-6600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. JEFFREY A JOHNSTON
Title or Position: PRESIDENT
Credential:
Phone: 314-251-6000