Healthcare Provider Details
I. General information
NPI: 1477957819
Provider Name (Legal Business Name): MERCY EMERGENCY CARE SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/14/2014
Last Update Date: 11/08/2024
Certification Date: 11/08/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2213 CHERRY ST
TOLEDO OH
43608-2603
US
IV. Provider business mailing address
307 S EVERGREEN AVE
WOODBURY NJ
08096-2739
US
V. Phone/Fax
- Phone: 419-251-3232
- Fax:
- Phone: 856-686-4304
- Fax: 865-560-7078
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207P00000X |
| Taxonomy | Emergency Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363A00000X |
| Taxonomy | Physician Assistant |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
STEPHEN
J
MURTAUGH
Title or Position: CFO
Credential:
Phone: 856-686-4394