Organization

Mercy Management Of Southeastern Pennsylvania

May also be knows as Mms-mercy Medical Associates At Eastwick

Internal Medicine Physician in Philadelphia, PA(View on Map)

Legal Business Name

Mercy Management Of Southeastern Pennsylvania

Also Known As

Mms-mercy Medical Associates At Eastwick

NPI Number

1194701292

NPI Type

Organization

Enumeration Date

12/20/2005

Specialties

(Taxonomies)

Code

207R00000X

Primary Taxonomy

Yes

Contact
Information

Purpose

Mailing
Location

Address

1 W ELM ST
2821 ISLAND AVE

City

Conshohocken
Philadelphia

State

PA
PA

Postal Code

19428-2007
19153-2300

Country

US
US

Telephone Number

(610) 567-6964
(215) 863-6110

Authorized Official

Name

Mr. Doug;as Smith

Title or Position

VP FINANCIAL SERVICES

Telephone Number

(610) 567-6964

Identifiers

Identifier

2234269001
2234269001
100778793 0152
125186900
2059546
1551070
1551070
2234269001
2234269001
Unknown
Unknown
Unknown
Unknown
Unknown
Unknown

Identifier State

PA
PA
PA
PA
PA
PA
PA
PA
PA
Unknown
Unknown
Unknown
Unknown
Unknown
Unknown

Identifier Issuer

AMERIHEALTH DELAWARE
KEYSTONE HEALTH PCP 65
Unknown
DEPT OF LABOR
AETNA MEDICARE
AMERIHEALTH ADMIN
BLUE SHIELD COMP
AMERIHEALTH NEW JERSEY
AMERIHEALTH HMO
Unknown
Unknown
Unknown
Unknown
Unknown
Unknown

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 05/09/2008

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