Organization
MERCY MANAGEMENT OF SE PA
Active
Parent organization
MERCY MANAGEMENT OF SE PA
Other names
Mercy Fitzgerald CRNA Services
Organization subpart
Yes
Provider details
NPI number
Legal business name
MERCY MANAGEMENT OF SE PA
Authorized official
GINA R CAMERON (DELEGATED OFFICIAL)
(610) 237-4280
Entity
Organization
Contact information
Practice address
1500 LANSDOWNE AVENUE, DARBY, PA 19023
(610) 237-4000
Mailing address
PO BOX 827675, PHILADELPHIA, PA 19182-7675
(856) 423-7700
(856) 423-0823
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007787930164
—
PA
01
—
DB6047
RAILROAD MEDICARE GROUP
—
Enumeration date
06/16/2006
Last updated
02/19/2008
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