1023053477 NPI number — MERCY ST. FRANCIS HOSPITAL

Table of content: (NPI 1023053477)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1023053477 NPI number — MERCY ST. FRANCIS HOSPITAL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MERCY ST. FRANCIS HOSPITAL
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:
1023053477
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/16/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
100 WEST HIGHWAY 60
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MOUNTAIN VIEW
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
65548-0082
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
417-934-7000
Provider Business Mailing Address Fax Number:
417-934-7197

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
100 WEST HIGHWAY 60
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MOUNTAIN VIEW
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
65548
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
417-934-7000
Provider Business Practice Location Address Fax Number:
417-934-7197
Provider Enumeration Date:
06/19/2006

Additional Information

Authorized Official

Authorized Official Last Name:
CLOUSEDAY
Authorized Official First Name:
SHERRY
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
417-820-8439

Provider Taxonomy Codes

  • Taxonomy code: 282NC0060X , with the licence number:  447-7 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 111065 . This is a "HEALTH LINK" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 8P159 . This is a "ARKANSAS BCBS-PHYSICIAN" identifier , issued by the state of ( AK ) . This identifiers is of the category "OTHER".
  • Identifier: 50046 . This is a "PREMIER-PHYSICIAN" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 260018 . This is a "PREMIER INPATIENT" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 83310 . This is a "ARKANSAS BCBS-INPATIENT" identifier , issued by the state of ( AK ) . This identifiers is of the category "OTHER".
  • Identifier: 540491602 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 120844105 , issued by the state of ( AR ) . This identifiers is of the category "MEDICAID".
  • Identifier: 010491603 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".




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