1932180205 NPI number — MERCY CATHOLIC MEDICAL CENTER OF SOUTHEASTERN PA

Table of content: (NPI 1932180205)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932180205 NPI number — MERCY CATHOLIC MEDICAL CENTER OF SOUTHEASTERN PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MERCY CATHOLIC MEDICAL CENTER OF SOUTHEASTERN PA
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:
1932180205
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/05/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
41 UNIVERSITY DR STE 106
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEWTOWN
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18940-1873
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
734-343-2654
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1503 LANSDOWNE AVE STE 2000
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DARBY
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19023-1330
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-237-2529
Provider Business Practice Location Address Fax Number:
610-534-6107
Provider Enumeration Date:
11/14/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
CUMMINGS
Authorized Official First Name:
KIMBERLY
Authorized Official Middle Name:
A
Authorized Official Title or Position:
VP, FINANCE AND CFO
Authorized Official Telephone Number:
215-710-2508

Provider Taxonomy Codes

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

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

  • Identifier: AD1794363 . This is a "HIGHMARK BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 2633205001 . This is a "KHPE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 10127 . This is a "KMHP" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".