Provider Demographics
NPI:1992916837
Name:ST,MARY,MEDICAL,CENTRE
Entity type:Organization
Organization Name:ST,MARY,MEDICAL,CENTRE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:HOUSE,DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MERCY
Authorized Official - Middle Name:
Authorized Official - Last Name:CHIRAYATH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-710-2000
Mailing Address - Street 1:1201,LANGHORNE,NEWTOWN,ST ,MARY,MEDICAL,CRE
Mailing Address - Street 2:
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047
Mailing Address - Country:US
Mailing Address - Phone:215-428-1282
Mailing Address - Fax:
Practice Address - Street 1:1201,LANGHORNE,NEWTOWN,ST ,MARY,MEDICAL,CRE
Practice Address - Street 2:
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047
Practice Address - Country:US
Practice Address - Phone:215-710-2000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD029038E282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital