Provider Demographics
NPI:1548431752
Name:MERCY EXPRESS CARE
Entity type:Organization
Organization Name:MERCY EXPRESS CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:VENITA
Authorized Official - Middle Name:
Authorized Official - Last Name:MILBURN
Authorized Official - Suffix:
Authorized Official - Credentials:RMA
Authorized Official - Phone:513-981-6643
Mailing Address - Street 1:4600 MCAULEY PL FL 6
Mailing Address - Street 2:MAIL DROP 05047
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45242-4733
Mailing Address - Country:US
Mailing Address - Phone:513-981-6643
Mailing Address - Fax:513-981-6176
Practice Address - Street 1:5440 DIXIE HWY
Practice Address - Street 2:SUITE G
Practice Address - City:FAIRFIELD
Practice Address - State:OH
Practice Address - Zip Code:45014-7488
Practice Address - Country:US
Practice Address - Phone:513-829-2161
Practice Address - Fax:513-829-2565
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-14
Last Update Date:2008-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center