Provider Demographics
NPI:1336606029
Name:MERCY LIFE CENTER CORPORATION
Entity type:Organization
Organization Name:MERCY LIFE CENTER CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PATIENT ACCOUNTING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:ANGLUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-697-0712
Mailing Address - Street 1:1200 REEDSDALE ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15233-2109
Mailing Address - Country:US
Mailing Address - Phone:412-697-0712
Mailing Address - Fax:412-323-4507
Practice Address - Street 1:249 S 9TH ST
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15203-1265
Practice Address - Country:US
Practice Address - Phone:412-488-4040
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MERCY LIFE CENTER CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-02-28
Last Update Date:2019-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy