Provider Demographics
NPI:1285998724
Name:MERCY CLINIC EAST COMMUNITIES
Entity type:Organization
Organization Name:MERCY CLINIC EAST COMMUNITIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR - FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:KERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:DUNGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-364-3707
Mailing Address - Street 1:301 THERESA ST
Mailing Address - Street 2:
Mailing Address - City:CUBA
Mailing Address - State:MO
Mailing Address - Zip Code:65453-1636
Mailing Address - Country:US
Mailing Address - Phone:573-677-2006
Mailing Address - Fax:
Practice Address - Street 1:301 THERESA ST
Practice Address - Street 2:
Practice Address - City:CUBA
Practice Address - State:MO
Practice Address - Zip Code:65453-1636
Practice Address - Country:US
Practice Address - Phone:573-677-2006
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MERCY HEALTH EAST COMMUNITIES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-06-29
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO597189802Medicaid