Provider Demographics
NPI:1043204316
Name:THE MERCY HOSPITAL INC
Entity type:Organization
Organization Name:THE MERCY HOSPITAL INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:REGIONAL DIRECTOR OF REIMBURSEMENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:M
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-714-4396
Mailing Address - Street 1:PO BOX 414432
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-4432
Mailing Address - Country:US
Mailing Address - Phone:413-748-9000
Mailing Address - Fax:
Practice Address - Street 1:271 CAREW ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01104
Practice Address - Country:US
Practice Address - Phone:413-748-9000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-01
Last Update Date:2019-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA35282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110027346BMedicaid
MA2222006630OtherBLUE CROSS OF MASS OP SUR
MA110027346AMedicaid
CT3023942Medicaid
MA2222006601OtherBLUE CROSS OF MASS INPT
MA2222006610OtherBLUE CROSS OF MASS OUTPT
CT3032356Medicaid
FL9091734Medicaid
MA2222006630OtherBLUE CROSS OF MASS OP SUR
MA2222006610OtherBLUE CROSS OF MASS OUTPT