Provider Demographics
NPI:1285664177
Name:MERCY HOSPITALS EAST COMMUNITIES
Entity Type:Organization
Organization Name:MERCY HOSPITALS EAST COMMUNITIES
Other - Org Name:MERCY HOSPITAL WASHINGTON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:THORN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:636-528-3329
Mailing Address - Street 1:PO BOX 18057B
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63150-8057
Mailing Address - Country:US
Mailing Address - Phone:636-239-8000
Mailing Address - Fax:
Practice Address - Street 1:901 E 5TH ST
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:MO
Practice Address - Zip Code:63090-3127
Practice Address - Country:US
Practice Address - Phone:636-239-8000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-04
Last Update Date:2020-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes282N00000XHospitalsGeneral Acute Care HospitalGroup - Single Specialty
No207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO155OtherBLUE CHOICE
MO590636908Medicaid
MO6350990OtherAETNA PPO
MO155OtherBLUE CROSS
MO0486418OtherAETNA HMO
MO138137OtherHEALTHLINK PROVIDER NUMBE
MO5040311OtherUHC
MO5057469Medicaid
MO010636900Medicaid
MO4625OtherGHP
MO8783X8783Medicaid
MO590636908Medicaid
MO8783X8783Medicaid
MO0486418OtherAETNA HMO