Provider Demographics
NPI:1881056190
Name:MERIT HEALTH WESLEY
Entity type:Organization
Organization Name:MERIT HEALTH WESLEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GME COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:HELON
Authorized Official - Middle Name:
Authorized Official - Last Name:LOFTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-268-8399
Mailing Address - Street 1:9 ELSON ST
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-7220
Mailing Address - Country:US
Mailing Address - Phone:646-238-4494
Mailing Address - Fax:
Practice Address - Street 1:5001 HARDY ST
Practice Address - Street 2:
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39402-1308
Practice Address - Country:US
Practice Address - Phone:601-296-3963
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-25
Last Update Date:2016-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital