Basic Information
| Provider Information | |||||||||
| NPI: | 1740714252 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | STEWARD SHARON REGIONAL HEALTH SYSTEM INC. | ||||||||
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| OtherOrganizationName: | MERCER FAMILY MEDICINE CENTER | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1900 N PEARL ST STE 2400 | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752012470 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6174194700 | ||||||||
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| Practice Location | |||||||||
| Address1: | 551 GREENVILLE RD | ||||||||
| Address2: | |||||||||
| City: | MERCER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 161375019 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7426624155 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/12/2017 | ||||||||
| LastUpdateDate: | 06/04/2019 | ||||||||
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| AuthorizedOfficialLastName: | DOYLE | ||||||||
| AuthorizedOfficialFirstName: | JOHN | ||||||||
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| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 4693418804 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QR1300X | Y | Ambulatory Health Care Facilities | Clinic/Center | Rural Health |
No ID Information.