Healthcare Provider Details

I. General information

NPI: 1790742427
Provider Name (Legal Business Name): COMMUNITY MERCY HEALTH PARTNERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2006
Last Update Date: 06/07/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 W HIGH ST
SPRINGFIELD OH
45502-1218
US

IV. Provider business mailing address

40 W HIGH ST
SPRINGFIELD OH
45502-1218
US

V. Phone/Fax

Practice location:
  • Phone: 937-322-4939
  • Fax:
Mailing address:
  • Phone: 937-322-4939
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0050X
TaxonomyNon-Surgical Family Planning Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. MARK S. WIENER
Title or Position: PRESIDENT & CEO
Credential:
Phone: 937-328-9515