Organization
MERCY MANAGEMENT OF SEPA
Active
Other names
Mercy Nutrition Associates
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DOUGLAS C SMITH (CREDENTIALING SPECIALIST)
(610) 567-6964
Entity
Organization
Contact information
Practice address
501 S 54TH ST, PHILADELPHIA, PA 19143-1900
(215) 748-9872
(215) 748-9869
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
133V00000X
Registered Dietitian
Primary
DN003282
PA
Other
Enumeration date
07/25/2006
Last updated
08/22/2020
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