Organization
MERCY FAMILY HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEXANDRA C UDE CPA (PRACTICE MANAGER)
(765) 864-0558
Entity
Organization
Contact information
Practice address
3804 SOUTHLAND AVE, KOKOMO, IN 46902-3637
(765) 864-0558
(765) 864-8370
Mailing address
3804 SOUTHLAND AVE, KOKOMO, IN 46902-3637
(765) 864-0558
(765) 864-8370
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
50004829A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200996390A
—
IN
Enumeration date
04/04/2007
Last updated
10/29/2019
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