Organization
MERCY MANAGEMENT OF SOUTHEASTERN PENNSYLVANIA
Active
Organization
MERCY MANAGEMENT OF SOUTHEASTERN PENNSYLVANIA
Active
Other names
Mercy Pulmonary Associates
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DOUGLAS SMITH (VP FINANCIAL SERVICES)
(610) 567-6951
Entity
Organization
Contact information
Practice address
1500 LANSDOWNE AVE, DARBY, PA 19023-1200
(610) 237-5683
(610) 567-6955
Mailing address
1500 LANSDOWNE AVE, DARBY, PA 19023-1200
(610) 567-6964
(610) 567-6170
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0032979000
KEYSTONE HEALTH PLAN EAST
PA
01
—
014647
HEALTH PARTNERS
PA
01
—
1003143
KEYSTONE MERCY HEALTH PLA
PA
05
—
1007787930112
—
PA
01
—
12518890
DEPARTMENT OF LABOR
PA
01
—
2805
BLUE SHIELD
PA
Enumeration date
12/20/2005
Last updated
05/08/2008
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