Healthcare Provider Details
I. General information
NPI: 1184062382
Provider Name (Legal Business Name): MERCY ST FRANCIS HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/10/2013
Last Update Date: 06/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1202 E MAIN ST
WILLOW SPRINGS MO
65793-3588
US
IV. Provider business mailing address
1202 E MAIN ST
WILLOW SPRINGS MO
65793-3588
US
V. Phone/Fax
- Phone: 417-469-1820
- Fax:
- Phone: 417-469-1820
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QR1300X |
| Taxonomy | Rural Health Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
SCOTT
REYNOLDS
Title or Position: VP-FINANCE
Credential:
Phone: 417-820-2818