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General NPI Number Information
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NPI Number | 1922108679
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Entity Type | Organization
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Legal Business Name | MERCY MEDICAL CENTER INC.
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Dates
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Enumeration Date | 09/23/2006
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Last Update Date | 09/30/2008
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Provider Practice Location Address
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Address Line | 2459 NW STEWART PKWY
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City | ROSEBURG
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State | OR
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Zip | 97471-1596
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Country | US
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Telephone | 541-677-4836
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Fax | 541-677-6568
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Provider Business Mailing Address
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Address Line | 2700 NW STEWART PKWY
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City | ROSEBURG
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State | OR
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Zip | 97471-1281
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Country | US
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Telephone | 541-677-4836
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Fax | 541-677-6568
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Authorized Official
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Title or Position | VICE PRESIDENT CFO
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Name | JOHN S. KASBERGER
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Credential |
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Telephone | 541-677-2458
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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