Organization
MERCY MEDICAL, A CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAKE BELL (CHIEF EXECUTIVE OFFICER)
(251) 621-4223
Entity
Organization
Contact information
Practice address
101 VILLA DR, DAPHNE, AL 36526-4653
(251) 626-2694
Mailing address
PO BOX 1090, DAPHNE, AL 36526-1090
Taxonomy
Speciality
Code
Description
License number
State
273Y00000X
Rehabilitation Hospital Unit
Primary
11761
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010-100
BCBS REHAB PROVIDER NUM
AL
01
—
9245
HEALTHSPRING OF AL
AL
Enumeration date
04/18/2006
Last updated
03/02/2012
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