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Organization
MERCY MANAGEMENT OF SOUTHEASTERN PENNSYLVANIA
Active
Organization
MERCY MANAGEMENT OF SOUTHEASTERN PENNSYLVANIA
Active
Other names
MMS-Mercy Hospital of Philadelphia
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DOUGLAS C SMITH (VP FINANCIAL SERVICES)
(610) 567-6964
Entity
Organization
Contact information
Practice address
501 S 54TH ST, PHILADELPHIA, PA 19143-1900
(215) 748-9707
(215) 748-9708
Mailing address
1 W ELM ST, 2ND FLOOR, CONSHOHOCKEN, PA 19428-2007
(610) 567-6964
(610) 567-6170
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
NULL
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100778793 0157
—
PA
01
—
125183600
DEPT OF LABOR
PA
01
—
1543646
BLUE SHIELD PA PR
PA
01
—
1543648
AMERIHEALTH ADMIN
PA
01
—
2228313000
AMERIHEALTH NEW JERSEY
PA
01
—
2507496
AETNA HMO SPECIALIST
PA
01
—
33695
HEALTH PARTNERS
PA
01
—
7770198
AETNA OTHER
PA
01
—
G000668600
AMERICHOICE
PA
Enumeration date
12/20/2005
Last updated
05/08/2008
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