Healthcare Provider Details

I. General information

NPI: 1619139250
Provider Name (Legal Business Name): MERCY HOSPITALS EAST COMMUNITIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2008
Last Update Date: 06/26/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

851 E 5TH ST SUITE 200
WASHINGTON MO
63090-3135
US

IV. Provider business mailing address

851 E 5TH ST SUITE 200
WASHINGTON MO
63090-3135
US

V. Phone/Fax

Practice location:
  • Phone: 636-239-8656
  • Fax:
Mailing address:
  • Phone: 636-239-8656
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: TERRI MCLAIN
Title or Position: PRESIDENT
Credential:
Phone: 636-239-8000