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General NPI Number Information
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NPI Number | 1609151471
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Entity Type | Organization
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Legal Business Name | MERCY HEALTH CLINICS, LLC
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Dates
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Enumeration Date | 10/12/2011
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Last Update Date | 05/02/2019
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Provider Practice Location Address
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Address Line | 1025 GRAND AVE
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City | BEATTYVILLE
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State | KY
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Zip | 41311-0000
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Country | US
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Telephone | 606-464-8806
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Fax | 606-464-9453
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Provider Business Mailing Address
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Address Line | PO BOX 636493
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City | CINCINNATI
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State | OH
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Zip | 45263-6493
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Country | US
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Telephone | 513-981-5130
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Fax | 513-981-5015
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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 | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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