Provider Demographics
NPI:1508237892
Name:M.E.R.C.I CLINIC
Entity Type:Organization
Organization Name:M.E.R.C.I CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:STAFF NURSE PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:DELURDES
Authorized Official - Last Name:DEHOYOS
Authorized Official - Suffix:
Authorized Official - Credentials:NP-C
Authorized Official - Phone:210-957-9988
Mailing Address - Street 1:31 HARBOR WALK
Mailing Address - Street 2:
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28562-8902
Mailing Address - Country:US
Mailing Address - Phone:210-957-9988
Mailing Address - Fax:
Practice Address - Street 1:1315 TATUM DR
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28560-4314
Practice Address - Country:US
Practice Address - Phone:252-633-1599
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-12
Last Update Date:2015-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5007638261QC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health