Provider Demographics
NPI:1427098169
Name:MERCY HOSPITALS EAST COMMUNITIES
Entity type:Organization
Organization Name:MERCY HOSPITALS EAST COMMUNITIES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCOFFIC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-251-1917
Mailing Address - Street 1:PO BOX 776084
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-8057
Mailing Address - Country:US
Mailing Address - Phone:314-364-4200
Mailing Address - Fax:
Practice Address - Street 1:615 S NEW BALLAS RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-8221
Practice Address - Country:US
Practice Address - Phone:314-251-6000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-08
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207P00000X, 207Q00000X, 207R00000X
MO282N00000X
MO0023413336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes282N00000XHospitalsGeneral Acute Care HospitalGroup - Single Specialty
No207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No3336L0003XSuppliersPharmacyLong Term Care PharmacyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO157OtherBLUE CROSS
MO010567402Medicaid
MO7449215OtherAETNA UCC SP
MO8785X8785Medicaid
MO6350740OtherAETNA PPO
MO4858OtherGHP
MO5075742Medicaid
MO0069376OtherAETNA HMO
MO103427OtherHEALTHLINK
MO5020301OtherUNC
MO5075742Medicaid
MO5020301OtherUNC
MO8785X8785Medicaid
MO260020Medicare Oscar/Certification