Provider Demographics
NPI:1982887865
Name:MERCY URGENT CARE
Entity Type:Organization
Organization Name:MERCY URGENT CARE
Other - Org Name:MERCY GENERAL URGENT CARE
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:REGIONAL DIR PHYS REV CYCLE
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:LOHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:231-672-2156
Mailing Address - Street 1:PO BOX 1847
Mailing Address - Street 2:
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49443-1847
Mailing Address - Country:US
Mailing Address - Phone:231-672-2120
Mailing Address - Fax:231-728-5981
Practice Address - Street 1:1700 OAK AVE
Practice Address - Street 2:
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49442-2407
Practice Address - Country:US
Practice Address - Phone:231-672-6430
Practice Address - Fax:231-672-6256
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MERCY HEALTH PARTNERS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-12-13
Last Update Date:2020-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI700F110760OtherBCN ONLY
MI0N27520Medicare PIN