Provider Demographics
NPI:1518018191
Name:DIGNITY HEALTH
Entity Type:Organization
Organization Name:DIGNITY HEALTH
Other - Org Name:MERCY MEDICAL CENTER MERCED
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:STRASSER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-564-5015
Mailing Address - Street 1:2740 M STREET
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95340
Mailing Address - Country:US
Mailing Address - Phone:209-384-6404
Mailing Address - Fax:209-384-6699
Practice Address - Street 1:333 MERCY AVE
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95340-8319
Practice Address - Country:US
Practice Address - Phone:209-564-5000
Practice Address - Fax:209-394-6699
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DIGNITY HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-12
Last Update Date:2013-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA040000178261QR1300X, 282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZR00444HMedicaid
ZZZC2404ZOtherBSCA - DOMINCAN CAMPUS
383738197OtherFEDERAL TAX ID
383738197953400031OtherTRICARE WPS
CAHSC00444IMedicaid
CAHSD00444GMedicaid
383738197953400000OtherTRICARE WPS
CAHSP40444IMedicaid
CAHSC00444HMedicaid
ZZZA2400ZOtherBSCA - COMMUNITY CAMPUS
CAHSP40444HMedicaid
CARHM19998HMedicaid
CAZZR00444IMedicaid
CAHSP40444IMedicaid
CAZZR00444HMedicaid