Provider Demographics
NPI:1831132133
Name:MERCY HEALTH PARTNERS
Entity Type:Organization
Organization Name:MERCY HEALTH PARTNERS
Other - Org Name:TRINITY HEALTH MUSKEGON HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:231-728-4809
Mailing Address - Street 1:1500 E SHERMAN BLVD
Mailing Address - Street 2:
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49444-1849
Mailing Address - Country:US
Mailing Address - Phone:231-672-2000
Mailing Address - Fax:
Practice Address - Street 1:1500 E SHERMAN BLVD
Practice Address - Street 2:
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49444-1849
Practice Address - Country:US
Practice Address - Phone:231-672-2000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-14
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI610010282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI00066OtherBCBSM
MI5170747Medicaid
MI1557275Medicaid
MI1557275Medicaid