Provider Demographics
NPI:1942349352
Name:MERCY PRIMARY CARE INC.
Entity Type:Organization
Organization Name:MERCY PRIMARY CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCAFFERTY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-232-5545
Mailing Address - Street 1:1400 LOCUST ST
Mailing Address - Street 2:SUITE 5108
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15219-5114
Mailing Address - Country:US
Mailing Address - Phone:412-232-5900
Mailing Address - Fax:412-232-8463
Practice Address - Street 1:1400 LOCUST ST
Practice Address - Street 2:SUITE 5108
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15219-5114
Practice Address - Country:US
Practice Address - Phone:412-232-5900
Practice Address - Fax:412-232-8463
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-05
Last Update Date:2007-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD057992L282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0018024600004Medicaid
PA072441Medicare PIN