Organization
MERCY MIDWEST LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL DAVIS (CFO)
(856) 437-5249
Entity
Organization
Contact information
Practice address
5714 CENTRAL AVE, PORTAGE, IN 46368-2949
(856) 437-5266
Mailing address
3109 POPLARWOOD CT, STE 301, RALEIGH, NC 27604-1011
(856) 437-5249
(856) 422-2577
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
12/01/2015
Last updated
12/01/2015
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