# ST MARY MERCY HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1629741095
- **Authorized official:** MICHAEL PAUL GUSHO (REGIONAL CFO)
- **Authorized official phone:** (734) 398-0642

## Contact information

- **Practice address:** 19000 ST JOES PKWY STE 100, LIVONIA, MI 48152-1477
- **Practice address phone:** (734) 743-4656
- **Practice address fax:** (734) 743-4369
- **Mailing address:** 20555 VICTOR PKWY, LIVONIA, MI 48152-7031
- **Mailing address phone:** (734) 343-3925
- **Mailing address fax:** (312) 957-3997

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 07/30/2021
- **Last updated:** 07/30/2021