Provider Demographics
NPI:1043272743
Name:MERCY PRIMARY CARE INC.
Entity type:Organization
Organization Name:MERCY PRIMARY CARE INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:TOMARO
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:412-571-1022
Mailing Address - Street 1:3089 SUSSEX AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15226-2516
Mailing Address - Country:US
Mailing Address - Phone:412-571-1022
Mailing Address - Fax:412-571-1032
Practice Address - Street 1:3089 SUSSEX AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15226-2516
Practice Address - Country:US
Practice Address - Phone:412-571-1022
Practice Address - Fax:412-571-1032
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOSO12846207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
095144LPKMedicare ID - Type Unspecified
PAI43407Medicare UPIN