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General NPI Number Information
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NPI Number | 1730218629
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Entity Type | Organization
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Legal Business Name | MERCY MEMORIAL HOSPITAL CORPORTATION
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Dates
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Enumeration Date | 03/05/2007
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 718 N MACOMB ST SUITE 305
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City | MONROE
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State | MI
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Zip | 48162-7815
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Country | US
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Telephone | 737-240-4100
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Fax |
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Provider Business Mailing Address
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Address Line | 718 N MACOMB ST SUITE 305
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City | MONROE
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State | MI
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Zip | 48162-7815
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Country | US
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Telephone | 737-240-4100
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Fax |
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Authorized Official
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Title or Position | PHARMACIST
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Name | PETER LIEBNER
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Credential |
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Telephone | 734-240-4100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 580030
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License Number State | MI
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