Organization
MERCY MANAGEMENT OF SOUTHEASTERN PENNSYLVANIA
Active
Other names
MMS-Mercy Oncology
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DOUGLAS C SMITH (VP FINANCIAL SERVICES)
(610) 567-6964
Entity
Organization
Contact information
Practice address
501 S 54TH ST, SUITE 186, PHILADELPHIA, PA 19143-1900
(215) 748-9530
(215) 748-9119
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
207RH0003X
Hematology & Oncology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
107787930162
—
PA
01
—
1783573
BLUE SHIELD
PA
01
—
2621808000
KEYSTONE HEALTH PLAN EAST
PA
01
—
30026505
KEYSTONE MERCY HEALTH PLA
PA
01
—
5674521
AUSHC HMO
PA
01
—
8496224
AUSHC PPO
PA
Enumeration date
12/22/2005
Last updated
05/25/2010
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