Provider Demographics
NPI:1326463357
Name:MERCY HEALTH PARTNERS
Entity Type:Organization
Organization Name:MERCY HEALTH PARTNERS
Other - Org Name:TRINITY HEALTH MEDICAL GROUP PRIMARY CARE WHITEHALL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:ALLORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:231-672-4888
Mailing Address - Street 1:905 E COLBY ST
Mailing Address - Street 2:
Mailing Address - City:WHITEHALL
Mailing Address - State:MI
Mailing Address - Zip Code:49461-1262
Mailing Address - Country:US
Mailing Address - Phone:231-728-5910
Mailing Address - Fax:231-728-5918
Practice Address - Street 1:905 E COLBY ST
Practice Address - Street 2:
Practice Address - City:WHITEHALL
Practice Address - State:MI
Practice Address - Zip Code:49461-1262
Practice Address - Country:US
Practice Address - Phone:231-728-5910
Practice Address - Fax:231-728-5918
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MERCY HEALTH PARTNERS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-02-27
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
238623Medicare Oscar/Certification