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General NPI Number Information
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NPI Number | 1356410526
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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 | 11/06/2006
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Last Update Date | 02/10/2012
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Provider Practice Location Address
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Address Line | 1210 DEADRA DR
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City | LEBANON
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State | MO
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Zip | 65536-4669
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Country | US
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Telephone | 417-588-5900
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Fax | 417-588-5911
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Provider Business Mailing Address
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Address Line | 1570 W BATTLEFIELD STREET SUITE 110
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City | SPRINGFIELD
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State | MO
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Zip | 65807-4163
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Country | US
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Telephone | 417-820-7492
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Fax | 417-820-5551
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Authorized Official
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Title or Position | VICE PRESIDENT FINANCE
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Name | SCOTT R REYNOLDS
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Credential |
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Telephone | 417-820-2818
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 159-22
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 15926HH
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 15928HH
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License Number State | MO
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