Provider Demographics
NPI:1336573393
Name:MERCY HEALTH WESTSHORE CARDIOLOGY SERVICES
Entity Type:Organization
Organization Name:MERCY HEALTH WESTSHORE CARDIOLOGY SERVICES
Other - Org Name:TRINITY HEALTH MEDICAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:STACEY
Authorized Official - Middle Name:
Authorized Official - Last Name:MERREN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:616-685-1837
Mailing Address - Street 1:1212 E SHERMAN BLVD
Mailing Address - Street 2:
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49444-1879
Mailing Address - Country:US
Mailing Address - Phone:231-672-3500
Mailing Address - Fax:231-672-6199
Practice Address - Street 1:1212 E SHERMAN BLVD
Practice Address - Street 2:
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49444-1879
Practice Address - Country:US
Practice Address - Phone:231-672-3500
Practice Address - Fax:231-672-6199
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MERCY HEALTH PARTNERS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-08-27
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty