Provider Demographics
NPI:1407286958
Name:MERCY SERVICES OF HEALTH
Entity Type:Organization
Organization Name:MERCY SERVICES OF HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:CRESCENT
Authorized Official - Last Name:NDUNGURU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-765-4499
Mailing Address - Street 1:930 KENNEDY ST NW
Mailing Address - Street 2:SUITE 300
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-2916
Mailing Address - Country:US
Mailing Address - Phone:240-765-4499
Mailing Address - Fax:
Practice Address - Street 1:930 KENNEDY ST NW
Practice Address - Street 2:SUITE 300
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-2916
Practice Address - Country:US
Practice Address - Phone:240-765-4499
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-20
Last Update Date:2013-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management