# MERCY MEDICAL LLC

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

## Provider details

- **NPI number:** 1932607306
- **Authorized official:** MR. CHALLEN WAYCHOFF III (COO/MANAGER)
- **Authorized official phone:** (480) 634-6400

## Contact information

- **Practice address:** 3367 S MERCY RD STE 201, GILBERT, AZ 85297-7604
- **Practice address phone:** (480) 634-6400
- **Practice address fax:** (480) 404-9649
- **Mailing address:** 3724 N 3RD ST STE 301, PHOENIX, AZ 85012-2035
- **Mailing address phone:** (480) 634-6400
- **Mailing address fax:** (480) 404-9649

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171M00000X | Case Manager/Care Coordinator | — | NULL | — |
| 171M00000X | Case Manager/Care Coordinator | — | — | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/31/2018
- **Last updated:** 03/19/2018