Provider Demographics
NPI:1083696454
Name:MERCY HEALTH SYSTEM, INC.
Entity Type:Organization
Organization Name:MERCY HEALTH SYSTEM, INC.
Other - Org Name:MERCY MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SR. VP AND GENERAL COUNSEL
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:PARRY
Authorized Official - Suffix:
Authorized Official - Credentials:ESQ
Authorized Official - Phone:239-552-3458
Mailing Address - Street 1:900 EAST OAK HILL AVENUE
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37917-4556
Mailing Address - Country:US
Mailing Address - Phone:865-545-8000
Mailing Address - Fax:865-545-3105
Practice Address - Street 1:900 EAST OAK HILL AVENUE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37917-4556
Practice Address - Country:US
Practice Address - Phone:865-545-8000
Practice Address - Fax:865-545-3105
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MERCY HEALTH PARTNERS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-11-18
Last Update Date:2011-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000000045282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3256808Medicare PIN