1285664177 NPI number — MERCY HOSPITALS EAST COMMUNITIES

Table of content: (NPI 1285664177)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285664177 NPI number — MERCY HOSPITALS EAST COMMUNITIES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MERCY HOSPITALS EAST COMMUNITIES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1285664177
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/13/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 18057B
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAINT LOUIS
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
63150-8057
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
636-239-8000
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
901 E 5TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
63090-3127
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
636-239-8000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/04/2006

Additional Information

Authorized Official

Authorized Official Last Name:
THORN
Authorized Official First Name:
MARK
Authorized Official Middle Name:
Authorized Official Title or Position:
EXECUTIVE DIRECTOR FINANCE
Authorized Official Telephone Number:
636-528-3329

Provider Taxonomy Codes

  • Taxonomy code: 207P00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207R00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 282N00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 155 . This is a "BLUE CHOICE" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 590636908 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 6350990 . This is a "AETNA PPO" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 155 . This is a "BLUE CROSS" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 0486418 . This is a "AETNA HMO" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 138137 . This is a "HEALTHLINK PROVIDER NUMBE" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 5040311 . This is a "UHC" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 5057469 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 010636900 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4625 . This is a "GHP" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 8783X8783 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".




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