Provider Demographics
NPI:1306876529
Name:MERCY PRIMARY CARE
Entity type:Organization
Organization Name:MERCY PRIMARY CARE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:STACEY
Authorized Official - Middle Name:
Authorized Official - Last Name:LANG
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:412-232-7545
Mailing Address - Street 1:275 CURRY HOLLOW RD
Mailing Address - Street 2:SUITE 100 BUILDING 1
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15236-4631
Mailing Address - Country:US
Mailing Address - Phone:412-650-2375
Mailing Address - Fax:412-650-2324
Practice Address - Street 1:275 CURRY HOLLOW RD
Practice Address - Street 2:SUITE 100 BUILDING 1
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15236-4631
Practice Address - Country:US
Practice Address - Phone:412-650-2375
Practice Address - Fax:412-650-2324
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0015821240088Medicaid
PA1389047OtherGROUP BC/BS NUMBER
PA1389047OtherGROUP BC/BS NUMBER