Healthcare Provider Details

I. General information

NPI: 1972531234
Provider Name (Legal Business Name): MERCY HOSPITAL SPRINGFIELD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2006
Last Update Date: 02/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1570 W BATTLEFIELD ST SUITE 110
SPRINGFIELD MO
65807-4163
US

IV. Provider business mailing address

1570 W BATTLEFIELD ST SUITE 110
SPRINGFIELD MO
65807-4163
US

V. Phone/Fax

Practice location:
  • Phone: 417-820-5550
  • Fax: 417-820-5551
Mailing address:
  • Phone: 417-820-5550
  • Fax: 417-820-5551

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code372500000X
TaxonomyChore Provider
License Number
License Number State

VIII. Authorized Official

Name: SCOTT R REYNOLDS
Title or Position: VICE PRESIDENT FINANCE
Credential:
Phone: 417-820-2818