MEDICARE: MERCY SERVICES, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083215305
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MERCY SERVICES, LLC

Provider Business Mailing Address
First Line	:	4855 S EMERSON AVE STE 202
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46203-6931
Country	:	US
Telephone Number	:	317-374-2593
Fax Number	:	317-981-1985

Provider Business Practice Location Address
First Line	:	4855 S EMERSON AVE STE 202
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46203-6931
Country	:	US
Telephone Number	:	317-374-2593
Fax Number	:	317-981-1985

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	BROOKE BAISE
Credential	:
Telephone Number	:	317-374-2593

Provider Enumeration Date	:	11/03/2020
Last Update Date	:	06/17/2024

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Directions to “MERCY SERVICES, LLC ” Practice Location

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