Provider Demographics
NPI:1689432817
Name:MERCYMED OF COLUMBUS INC
Entity Type:Organization
Organization Name:MERCYMED OF COLUMBUS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:TONY
Authorized Official - Middle Name:
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-507-9209
Mailing Address - Street 1:3702 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31904-7408
Mailing Address - Country:US
Mailing Address - Phone:706-507-9209
Mailing Address - Fax:706-507-9249
Practice Address - Street 1:3702 2ND AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904-7408
Practice Address - Country:US
Practice Address - Phone:706-507-9209
Practice Address - Fax:706-507-9249
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MERCYMED OF COLUMBUS, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-03-12
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy