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General NPI Number Information
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NPI Number | 1184453748
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Entity Type | Organization
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Legal Business Name | MERCY MEDICAL HEALTH CENTER
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Dates
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Enumeration Date | 07/31/2024
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Last Update Date | 03/14/2025
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Provider Practice Location Address
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Address Line | 600 FACTORY OUTLET DR STE 12
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City | ARCADIA
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State | LA
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Zip | 71001-3057
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Country | US
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Telephone | 318-781-2310
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Fax | 318-781-2312
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Provider Business Mailing Address
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Address Line | PO BOX 70
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City | HODGE
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State | LA
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Zip | 71247-0070
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Country | US
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Telephone | 318-259-1100
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Fax | 318-259-1333
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Authorized Official
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Title or Position | CEO
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Name | KIMBERLY G. BRUNSON
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Credential |
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Telephone | 318-259-1100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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