Provider Demographics
NPI:1609193838
Name:MERCY MANAGEMENT OF SEPA
Entity Type:Organization
Organization Name:MERCY MANAGEMENT OF SEPA
Other - Org Name:MMS-MERCY INTERVENTIONAL CARDIOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR - PHYSICIANS BILLING
Authorized Official - Prefix:
Authorized Official - First Name:GINA
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMERON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-567-5148
Mailing Address - Street 1:ONE WEST ELM STREET
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CONSHOHOCKEN
Mailing Address - State:PA
Mailing Address - Zip Code:19428-4108
Mailing Address - Country:US
Mailing Address - Phone:610-567-5513
Mailing Address - Fax:610-567-6170
Practice Address - Street 1:1500 LANSDOWNE AVE
Practice Address - Street 2:
Practice Address - City:DARBY
Practice Address - State:PA
Practice Address - Zip Code:19023-1200
Practice Address - Country:US
Practice Address - Phone:610-237-2525
Practice Address - Fax:610-567-6170
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-28
Last Update Date:2010-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Single Specialty