Provider Demographics
NPI:1003965344
Name:MERCY HOME CARE, INC.
Entity Type:Organization
Organization Name:MERCY HOME CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:SVETLANA
Authorized Official - Middle Name:
Authorized Official - Last Name:LUCHIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-482-2400
Mailing Address - Street 1:1030 N KINGS HWY
Mailing Address - Street 2:SUITE 300
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08034-1907
Mailing Address - Country:US
Mailing Address - Phone:856-482-2400
Mailing Address - Fax:856-482-2404
Practice Address - Street 1:1030 N KINGS HWY
Practice Address - Street 2:SUITE 300
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-1907
Practice Address - Country:US
Practice Address - Phone:856-482-2400
Practice Address - Fax:856-482-2404
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MERCY HOME CARE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-09
Last Update Date:2011-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJHP0250100251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8701202Medicaid