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General NPI Number Information
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NPI Number | 1104378132
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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 | 10/25/2016
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Last Update Date | 10/25/2016
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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 | 734-655-3400
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Fax |
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Provider Business Mailing Address
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Address Line | 36832 GARDNER ST
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City | LIVONIA
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State | MI
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Zip | 48152-2780
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Country | US
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Telephone | 248-302-0291
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | MRS. MEREDITH CHAPEL
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Credential | NP-C
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Telephone | 248-302-0291
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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 | AG0816083
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License Number State | MI
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