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General NPI Number Information
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NPI Number | 1235186842
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Entity Type | Organization
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Legal Business Name | MERCY HOSPITAL SPRINGFIELD
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Dates
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Enumeration Date | 05/28/2006
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Last Update Date | 11/03/2017
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Provider Practice Location Address
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Address Line | 101 N MAIN ST
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City | LICKING
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State | MO
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Zip | 65542-9026
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Country | US
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Telephone | 573-674-2922
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Fax | 573-674-4334
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Provider Business Mailing Address
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Address Line | 101 N MAIN ST
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City | LICKING
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State | MO
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Zip | 65542-9026
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Country | US
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Telephone | 573-674-2922
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Fax | 573-674-4334
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Authorized Official
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Title or Position | EXEC DIR-RETAIL PHARMACY SVCS
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Name | MR. PATRICK BERRY
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Credential |
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Telephone | 314-628-5606
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 2011020758
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 2011020758
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License Number State | MO
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