Provider Demographics
NPI:1528798840
Name:MERCY HEALTH CARE SERVICES, LLC
Entity type:Organization
Organization Name:MERCY HEALTH CARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MARTYN
Authorized Official - Middle Name:CHUKWUMA
Authorized Official - Last Name:ANAGBOGU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-332-9404
Mailing Address - Street 1:208 GEORGETOWNE DR
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:NC
Mailing Address - Zip Code:27520-1847
Mailing Address - Country:US
Mailing Address - Phone:919-298-2555
Mailing Address - Fax:
Practice Address - Street 1:86 OLD ROBERTS RD STE 103 A
Practice Address - Street 2:
Practice Address - City:BENSON
Practice Address - State:NC
Practice Address - Zip Code:27504
Practice Address - Country:US
Practice Address - Phone:919-298-2555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-10
Last Update Date:2022-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies