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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