Healthcare Provider Details

I. General information

NPI: 1306997655
Provider Name (Legal Business Name): HALL- MERCER CMH-MRC OF PA HOSP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/15/2007
Last Update Date: 03/30/2023
Certification Date: 03/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

245 S 8TH ST
PHILADELPHIA PA
19106-3520
US

IV. Provider business mailing address

245 S 8TH ST
PHILADELPHIA PA
19106-3520
US

V. Phone/Fax

Practice location:
  • Phone: 215-349-5150
  • Fax: 215-615-0432
Mailing address:
  • Phone: 215-349-5150
  • Fax: 215-615-0432

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MR. THOMAS MCCORMICK
Title or Position: ASSISTANCE VICE PRESIDENT
Credential:
Phone: 215-662-2709