Provider Demographics
NPI:1063419141
Name:MERCY MEDICAL
Entity type:Organization
Organization Name:MERCY MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MGR.-PATIENT FINANCIAL SERVICES
Authorized Official - Prefix:MR
Authorized Official - First Name:L.
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:SASSER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-626-4250
Mailing Address - Street 1:PO BOX 1090
Mailing Address - Street 2:
Mailing Address - City:DAPHNE
Mailing Address - State:AL
Mailing Address - Zip Code:36526-1090
Mailing Address - Country:US
Mailing Address - Phone:251-621-4250
Mailing Address - Fax:251-621-4234
Practice Address - Street 1:101 VILLA DR
Practice Address - Street 2:
Practice Address - City:DAPHNE
Practice Address - State:AL
Practice Address - Zip Code:36526-4653
Practice Address - Country:US
Practice Address - Phone:251-621-4250
Practice Address - Fax:251-621-4234
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL10310283X00000X
AL10459314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered283X00000XHospitalsRehabilitation Hospital
Not Answered314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility