Provider Demographics
NPI:1992930283
Name:MERCY WOMEN'S CENTER
Entity type:Organization
Organization Name:MERCY WOMEN'S CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SUSANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:NELMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-549-4892
Mailing Address - Street 1:18797 ALBERTA ST
Mailing Address - Street 2:
Mailing Address - City:ONEIDA
Mailing Address - State:TN
Mailing Address - Zip Code:37841-2127
Mailing Address - Country:US
Mailing Address - Phone:423-907-1686
Mailing Address - Fax:
Practice Address - Street 1:18797 ALBERTA ST
Practice Address - Street 2:
Practice Address - City:ONEIDA
Practice Address - State:TN
Practice Address - Zip Code:37841-2127
Practice Address - Country:US
Practice Address - Phone:423-907-1686
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MERCY PHYSICIANS SERVICES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-05-15
Last Update Date:2010-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3373630Medicare Oscar/Certification