Provider Demographics
NPI:1770006454
Name:MERCY MEDICAL MINISTRY
Entity Type:Organization
Organization Name:MERCY MEDICAL MINISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:BELL
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:334-501-1081
Mailing Address - Street 1:8897 TARA LN
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36830-8247
Mailing Address - Country:US
Mailing Address - Phone:334-728-9337
Mailing Address - Fax:
Practice Address - Street 1:1702 CATHERINE CT
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:AL
Practice Address - Zip Code:36830-5755
Practice Address - Country:US
Practice Address - Phone:334-501-1081
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-25
Last Update Date:2017-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty