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Organization
MERCY MANAGEMENT OF SEPA
Active
Organization
MERCY MANAGEMENT OF SEPA
Active
Other names
Mercy Health Associates
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DON HALBERSTADT (CFO)
(610) 567-6964
Entity
Organization
Contact information
Practice address
5630 CHESTNUT ST, PHILADELPHIA, PA 19139-3232
(215) 748-3100
(610) 748-1586
Mailing address
1 WEST ELM STREET, 2ND FLOOR, PHILADELPHIA, PA 19482
(610) 567-6964
(610) 567-6170
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007787930163
—
PA
01
—
1555770
BLUE SHIELD
PA
01
—
18027
AETNA HMO
PA
01
—
2247379000
KEYSTONE MERCY HEALTH PLA
PA
01
—
30011129
KEYSTONE MERCY HEALTH PLA
PA
01
—
33699
HEALTH PARTNERS
PA
01
—
5325477
AETNA PPO
PA
01
—
61258870002
CIGNA
PA
01
—
DA5351
RAILROAD MEDICARE
PA
Enumeration date
10/24/2005
Last updated
01/31/2008
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