Provider Demographics
NPI:1447870787
Name:MERCY HEARTS HEALTH SERVICES LLC
Entity type:Organization
Organization Name:MERCY HEARTS HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DOLAPO
Authorized Official - Middle Name:
Authorized Official - Last Name:OLOWU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-279-8066
Mailing Address - Street 1:4023 DAYTON RD
Mailing Address - Street 2:
Mailing Address - City:DREXEL HILL
Mailing Address - State:PA
Mailing Address - Zip Code:19026-5118
Mailing Address - Country:US
Mailing Address - Phone:267-279-8066
Mailing Address - Fax:
Practice Address - Street 1:4023 DAYTON RD
Practice Address - Street 2:
Practice Address - City:DREXEL HILL
Practice Address - State:PA
Practice Address - Zip Code:19026-5118
Practice Address - Country:US
Practice Address - Phone:267-279-8066
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-16
Last Update Date:2020-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA7017525OtherSECRETARY OF STATE ENTITY NUMBER