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Organization
MERCY MANAGEMENT OF SOUTHEASTERN PENNSYLVANIA
Active
Organization
MERCY MANAGEMENT OF SOUTHEASTERN PENNSYLVANIA
Active
Other names
MMS-Mercy Family Health Care Associates
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DOUGLAS C SMITH (VP FINANCIAL SVCS)
(610) 567-6964
Entity
Organization
Contact information
Practice address
5070 PARKSIDE AVE, SUITE 50100, PHILADELPHIA, PA 19131-4747
(215) 473-4700
(215) 473-1515
Mailing address
1 W ELM ST, 2ND FLOOR, CONSHOHOCKEN, PA 19428-2007
(610) 567-6964
(610) 567-6964
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0019352
AETNA HMO
PA
05
—
1007787930156
—
PA
01
—
125183500
DEPARTMENT OF LABOR
PA
01
—
1549288
BLUE SHIELD
PA
01
—
2233322001
KEYSTONE HEALTH PLAN EAST
PA
01
—
30010782
KEYSTONE MERCY HEALTH PLA
PA
01
—
5253340
AETNA PPO
PA
Enumeration date
11/29/2005
Last updated
05/09/2008
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