Mercy Midwest LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

MERCY MIDWEST LLC

Practice address

5714 Central Ave
Portage, IN 46368-2949

Phone

(856) 437-5266

NPI assigned

Dec 1, 2015

Last updated

Dec 1, 2015By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Michael Davis

Title

Cfo

Phone

(856) 437-5249

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1448928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1448928000000",
    "number": "1437524501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3109 POPLARWOOD CT",
            "address_2": "STE 301",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276041011",
            "telephone_number": "856-437-5249",
            "fax_number": "856-422-2577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5714 CENTRAL AVE",
            "city": "PORTAGE",
            "state": "IN",
            "postal_code": "463682949",
            "telephone_number": "856-437-5266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY MIDWEST LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-01",
        "last_updated": "2015-12-01",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "856-437-5249",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Meijer Stores Limited Partnership (Meijer Pharmacy #266)
• Melody Home Care Services LLC
• Elizabeth E Menges, OTR
• Gretchen Mercer, SLP
• Mercy Diagnostics Inc
• Chloe Meredith
• Kelleen Merrell, IBCLC
• Louis Miceli, DO
• Bethany Michielsen, FNP-C
• Michigan City Family Dentistry (Portage Dental Rehab Center)

• Clinical Medical Laboratory in Portage, IN
• Providers in Portage, IN by specialty
• Clinical Medical Laboratory in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.