Provider Demographics
NPI:1326793100
Name:MERCY HEALTHCARE SERVICES
Entity Type:Organization
Organization Name:MERCY HEALTHCARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:ODUKOYA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-509-6228
Mailing Address - Street 1:6400 OLD CHAPEL TER
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20720-4609
Mailing Address - Country:US
Mailing Address - Phone:202-509-6228
Mailing Address - Fax:
Practice Address - Street 1:6400 OLD CHAPEL TER
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20720-4609
Practice Address - Country:US
Practice Address - Phone:202-509-6228
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-19
Last Update Date:2022-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health