Provider Demographics
NPI:1417574112
Name:MERCY HOME HEALTH
Entity Type:Organization
Organization Name:MERCY HOME HEALTH
Other - Org Name:MERCY HOME HEALTH - MOM-BABY
Other - Org Type:Other Name
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MARCUS
Authorized Official - Middle Name:
Authorized Official - Last Name:BOWENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-283-4006
Mailing Address - Street 1:1001 BALTIMORE PIKE STE 310
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:19064-2800
Mailing Address - Country:US
Mailing Address - Phone:610-690-2597
Mailing Address - Fax:610-350-7399
Practice Address - Street 1:1001 BALTIMORE PIKE STE 310
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:PA
Practice Address - Zip Code:19064-2800
Practice Address - Country:US
Practice Address - Phone:610-690-2597
Practice Address - Fax:610-350-7399
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-29
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health