Organization
MERCY ACO PROVIDER SERVICES LLC
Active
Parent organization
MERCY HEALTH
Organization subpart
Yes
Provider details
NPI number
Legal business name
MERCY HEALTH
Authorized official
MR. SHANNON SOCK (PRESIDENT MERCY ACO)
(314) 251-6000
Entity
Organization
Contact information
Practice address
615 S NEW BALLAS RD, SAINT LOUIS, MO 63141-8221
(314) 251-1376
Mailing address
625 S NEW BALLAS RD, SUITE 7020, SAINT LOUIS, MO 63141-8253
(314) 251-1376
(314) 251-1394
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
207RC0001X
Clinical Cardiac Electrophysiology Physician
—
—
207RI0200X
Infectious Disease Physician
—
—
282N00000X
General Acute Care Hospital
Primary
—
—
Other
Enumeration date
06/04/2013
Last updated
01/08/2014
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