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General NPI Number Information
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NPI Number | 1013649557
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Entity Type | Organization
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Legal Business Name | ST MARY MERCY HOSPITAL
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Dates
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Enumeration Date | 06/24/2022
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Last Update Date | 11/21/2025
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Provider Practice Location Address
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Address Line | 36475 FIVE MILE RD
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City | LIVONIA
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State | MI
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Zip | 48154-1971
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Country | US
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Telephone | 734-655-4800
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Fax |
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Provider Business Mailing Address
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Address Line | 20555 VICTOR PKWY MAILSTOP 3A
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City | LIVONIA
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State | MI
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Zip | 48152-7031
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Country | US
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Telephone | 734-343-3925
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Fax |
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Authorized Official
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Title or Position | REGIONAL CFO
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Name | MICHAEL PAUL GUSHO
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Credential |
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Telephone | 231-672-3886
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 174H00000X
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Taxonomy Name | Health Educator
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License Number |
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License Number State |
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