Provider Demographics
NPI:1134673148
Name:MERCY EAST AMBULATORY SERVICES LLC
Entity Type:Organization
Organization Name:MERCY EAST AMBULATORY SERVICES LLC
Other - Org Name:MERCY URGENT CARE
Other - Org Type:Other Name
Authorized Official - Title/Position:MANAGER MERCY REVENUE CYCLE
Authorized Official - Prefix:
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:S
Authorized Official - Last Name:FERGUSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-543-6946
Mailing Address - Street 1:PO BOX 775641
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-5641
Mailing Address - Country:US
Mailing Address - Phone:636-206-2665
Mailing Address - Fax:
Practice Address - Street 1:1722 CLARKSON RD
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-4976
Practice Address - Country:US
Practice Address - Phone:636-206-2665
Practice Address - Fax:636-206-2664
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-08
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care