Provider Demographics
NPI:1144282583
Name:MERCY MEDICAL CENTER INC
Entity type:Organization
Organization Name:MERCY MEDICAL CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:DEIBEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-659-2905
Mailing Address - Street 1:PO BOX 829923
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19182-9923
Mailing Address - Country:US
Mailing Address - Phone:410-951-1700
Mailing Address - Fax:410-951-1719
Practice Address - Street 1:301 SAINT PAUL PL
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21202-2102
Practice Address - Country:US
Practice Address - Phone:410-951-1700
Practice Address - Fax:410-951-1719
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-03
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD573490-01OtherCAREFIRST BC/BS OF MD
MD000095700Medicaid
MDMB6OtherCAREFIRST - BLUE CHOICE
MD210008Medicare PIN