Provider Demographics
NPI:1508925702
Name:MERCY FAMILY SUPPORT
Entity Type:Organization
Organization Name:MERCY FAMILY SUPPORT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR-FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:BERTOLINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-690-2597
Mailing Address - Street 1:1001 BALTIMORE PIKE
Mailing Address - Street 2:SUITE 310
Mailing Address - City:SPRINGFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:19064-2852
Mailing Address - Country:US
Mailing Address - Phone:610-690-2597
Mailing Address - Fax:610-690-2570
Practice Address - Street 1:1001 BALTIMORE PIKE
Practice Address - Street 2:SUITE 310
Practice Address - City:SPRINGFIELD
Practice Address - State:PA
Practice Address - Zip Code:19064-2852
Practice Address - Country:US
Practice Address - Phone:610-690-2597
Practice Address - Fax:610-690-2570
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MERCY HOME HEALTH SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-12-06
Last Update Date:2009-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health