Healthcare Provider Details

I. General information

NPI: 1255156048
Provider Name (Legal Business Name): MERCY PRIMARY CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/18/2024
Last Update Date: 11/18/2024
Certification Date: 11/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

249 S 9TH ST
PITTSBURGH PA
15203-1265
US

IV. Provider business mailing address

249 S 9TH ST
PITTSBURGH PA
15203-1265
US

V. Phone/Fax

Practice location:
  • Phone: 412-697-3260
  • Fax:
Mailing address:
  • Phone: 412-697-3260
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: DAVID GRABOWSKI
Title or Position: COO
Credential:
Phone: 412-323-4565