# MERCY ACO PROVIDER SERVICES LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** MERCY HEALTH
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1053759704
- **Legal business name:** MERCY HEALTH
- **Authorized official:** MR. SHANNON SOCK (PRESIDENT MERCY ACO)
- **Authorized official phone:** (314) 251-6000

## Contact information

- **Practice address:** 615 S NEW BALLAS RD, SAINT LOUIS, MO 63141-8221
- **Practice address phone:** (314) 251-1376
- **Mailing address:** 625 S NEW BALLAS RD, SUITE 7020, SAINT LOUIS, MO 63141-8253
- **Mailing address phone:** (314) 251-1376
- **Mailing address fax:** (314) 251-1394

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207N00000X | Dermatology Physician | — | NULL | — |
| 207N00000X | Dermatology Physician | — | — | — |
| 207RC0000X | Cardiovascular Disease Physician | — | NULL | — |
| 207RC0000X | Cardiovascular Disease Physician | — | — | — |
| 207RC0001X | Clinical Cardiac Electrophysiology Physician | — | NULL | — |
| 207RC0001X | Clinical Cardiac Electrophysiology Physician | — | — | — |
| 207RI0200X | Infectious Disease Physician | — | NULL | — |
| 207RI0200X | Infectious Disease Physician | — | — | — |
| 282N00000X | General Acute Care Hospital | — | NULL | Yes |

## Other

- **Enumeration date:** 06/04/2013
- **Last updated:** 01/08/2014