MEDICARE: MERCY CENTER NURSING UNIT

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	314000000X	Skilled Nursing Facility	015502	PA

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	:	1649264672
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MERCY CENTER NURSING UNIT

Provider Business Mailing Address
First Line	:	PO BOX 370
Second Line	:
City	:	DALLAS
State	:	PA
Zip	:	18612-0370
Country	:	US
Telephone Number	:	570-675-2131
Fax Number	:	570-674-5658

Provider Business Practice Location Address
First Line	:	301 LAKE ST
Second Line	:
City	:	DALLAS
State	:	PA
Zip	:	18612-7752
Country	:	US
Telephone Number	:	570-675-2131
Fax Number	:	570-674-7606

Authorized Official
Title or Position	:	NURSING HOME ADMINISTRATOR
Name	:	MS. SARA SWEENEY
Credential	:	NHA
Telephone Number	:	570-675-2131

Provider Enumeration Date	:	09/06/2005
Last Update Date	:	08/24/2015

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Directions to “MERCY CENTER NURSING UNIT ” Practice Location

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