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General NPI Number Information
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NPI Number | 1477765204
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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 | 05/04/2007
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Last Update Date | 01/31/2012
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Provider Practice Location Address
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Address Line | 675 NORTH HIGHWAY 5
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City | CAMDENTON
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State | MO
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Zip | 65020-3561
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Country | US
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Telephone | 573-346-1026
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Fax |
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Provider Business Mailing Address
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Address Line | 1235 E CHEROKEE ST
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City | SPRINGFIELD
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State | MO
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Zip | 65804-2203
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Country | US
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Telephone | 417-820-2000
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT - FINANCE
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Name | MR. 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 | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | 029068
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License Number State | MO
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