Provider Demographics
NPI:1356836746
Name:MERCY HOME MEDICAL SUPPLY INC.
Entity type:Organization
Organization Name:MERCY HOME MEDICAL SUPPLY INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:HASAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-779-2334
Mailing Address - Street 1:3801 SYCAMORE DAIRY RD STE E
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28303-3420
Mailing Address - Country:US
Mailing Address - Phone:910-779-2334
Mailing Address - Fax:910-779-2326
Practice Address - Street 1:3801 SYCAMORE DAIRY RD STE E
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28303-3420
Practice Address - Country:US
Practice Address - Phone:910-779-2334
Practice Address - Fax:910-779-2326
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MERCY HOME MEDICAL SUPPLY INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-06-27
Last Update Date:2018-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)