Healthcare Provider Details

I. General information

NPI: 1861486698
Provider Name (Legal Business Name): MERCY CATHOLIC MEDICAL CENTER OF SOUTHEASTERN PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2005
Last Update Date: 11/05/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 S 54TH ST
PHILADELPHIA PA
19143-1900
US

IV. Provider business mailing address

1 W ELM ST SUITE 100
CONSHOHOCKEN PA
19428-2007
US

V. Phone/Fax

Practice location:
  • Phone: 215-748-9000
  • Fax:
Mailing address:
  • Phone: 610-567-6000
  • Fax: 610-567-6611

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number State

VIII. Authorized Official

Name: MR. JOSEPH H BRADLEY
Title or Position: CFO
Credential:
Phone: 610-567-6771