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General NPI Number Information
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NPI Number | 1871094052
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Entity Type | Organization
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Legal Business Name | MERCY SOUTHERN MISSOURI AMBULATORY SERVICES LLC
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Dates
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Enumeration Date | 02/23/2018
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Last Update Date | 04/30/2025
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Provider Practice Location Address
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Address Line | 900 E BATTLEFIELD ST STE 124
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City | SPRINGFIELD
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State | MO
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Zip | 65807-5208
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Country | US
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Telephone | 417-556-8967
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Fax | 417-556-8968
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Provider Business Mailing Address
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Address Line | 620 S GLENSTONE AVE
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City | SPRINGFIELD
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State | MO
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Zip | 65802-3206
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Country | US
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Telephone | 417-556-8967
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Fax | 417-556-8968
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Authorized Official
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Title or Position | VP - ACCOUNTING
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Name | JILL MCCART
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Credential |
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Telephone | 314-364-3891
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State | MO
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