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General NPI Number Information
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NPI Number | 1093132946
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Entity Type | Organization
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Legal Business Name | MERCY HOSPITAL
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Dates
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Enumeration Date | 03/27/2014
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Last Update Date | 03/27/2014
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Provider Practice Location Address
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Address Line | 175 FORE RIVER PKWY
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City | PORTLAND
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State | ME
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Zip | 04102-2779
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Country | US
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Telephone | 207-553-6105
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Fax | 207-553-6168
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Provider Business Mailing Address
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Address Line | 175 FORE RIVER PKWY
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City | PORTLAND
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State | ME
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Zip | 04102-2779
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Country | US
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Telephone | 207-553-6105
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Fax | 207-553-6168
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Authorized Official
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Title or Position | REIMBURSEMENT TECH
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Name | MISS THERESA MARIE HUCK
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Credential | CPAT
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Telephone | 207-831-5995
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 37636
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License Number State | ME
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