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NPI Code Detail

MEDICARE: MERCY SACRED HEART, INC.

MEDICARE: MERCY SACRED HEART, INC.
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
1313M00000XNursing Facility/Intermediate Care Facility100248KY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1518954114
Entity Type Code : Organization
Provider Name (Legal Business Name) : MERCY SACRED HEART, INC.
Provider Business Mailing Address
First Line : 2120 PAYNE ST
Second Line :
City : LOUISVILLE
State : KY
Zip : 40206-2012
Country : US
Telephone Number : 502-895-9425
Fax Number : 502-894-9619
Provider Business Practice Location Address
First Line : 2120 PAYNE ST
Second Line :
City : LOUISVILLE
State : KY
Zip : 40206-2012
Country : US
Telephone Number : 502-895-9425
Fax Number : 502-894-9619
Authorized Official
Title or Position : CFO
Name : MR. WILLIAM ROBERT LEE
Credential : CPA
Telephone Number : 502-357-5534
Provider Enumeration Date : 09/29/2005
Last Update Date : 09/06/2023

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Directions to “MERCY SACRED HEART, INC. ” Practice Location

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