Organization
MERCY HOSPITAL INC
Active
Parent organization
MERCY HOSPITAL INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
MERCY HOSPITAL INC
Authorized official
MR. ROYCE HOLDEMAN (CFO)
(620) 345-6391
Entity
Organization
Contact information
Practice address
218 E. PACK STREET, MOUNDRIDGE, KS 67107-0180
(620) 345-6391
(620) 345-6344
Mailing address
PO BOX 180, 218 E. PACK STREET, MOUNDRIDGE, KS 67107-0180
Taxonomy
Speciality
Code
Description
License number
State
275N00000X
Medicare Defined Swing Bed Hospital Unit
Primary
H059003
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000424
BLUE CROSS BLUE SHIELD SW
KS
Enumeration date
08/01/2006
Last updated
02/23/2009
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