Healthcare Provider Details

I. General information

NPI: 1144401308
Provider Name (Legal Business Name): MERCY HOSPITAL SPRINGFIELD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2007
Last Update Date: 04/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

594 OLD ROUTE 66
ST ROBERT MO
65584-3729
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 573-336-4111
  • Fax: 573-336-4210
Mailing address:
  • Phone: 417-820-5550
  • Fax: 417-820-5551

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

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