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General NPI Number Information
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NPI Number | 1285632109
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Entity Type | Organization
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Legal Business Name | MERCY HEALTH-MARCUM & WALLACE HOSPITAL LLC
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Dates
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Enumeration Date | 07/13/2005
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 60 MERCY CT
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City | IRVINE
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State | KY
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Zip | 40336-1331
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Country | US
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Telephone | 606-723-2115
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Fax | 606-723-2951
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Provider Business Mailing Address
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Address Line | 60 MERCY CT
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City | IRVINE
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State | KY
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Zip | 40336-1331
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Country | US
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Telephone | 606-723-2115
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Fax | 606-723-2951
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. TRENA LYNN STOCKER
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Credential |
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Telephone | 859-779-0148
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NC0060X
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Taxonomy Name | Critical Access Hospital
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License Number |
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License Number State | KY
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