Provider Demographics
NPI:1053597203
Name:MERCY EXPRESSCARE
Entity type:Organization
Organization Name:MERCY EXPRESSCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:
Authorized Official - Last Name:PETTIGREW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-981-6251
Mailing Address - Street 1:4600 MCAULEY PLACE
Mailing Address - Street 2:6TH FLOOR
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45242-4733
Mailing Address - Country:US
Mailing Address - Phone:513-981-6251
Mailing Address - Fax:513-981-6118
Practice Address - Street 1:5440 DIXIE HIGHWAY
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:OH
Practice Address - Zip Code:45014-4108
Practice Address - Country:US
Practice Address - Phone:513-674-6000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MERCY FRANCISCAN MEDICAL MANAGEMENT SERVICES INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-01-18
Last Update Date:2008-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health