Provider Demographics
NPI:1730182742
Name:MERCY CARDIOLOGY LLC
Entity type:Organization
Organization Name:MERCY CARDIOLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:G
Authorized Official - Last Name:HERMANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-364-3380
Mailing Address - Street 1:625 S NEW BALLAS RD
Mailing Address - Street 2:STE 2030
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-8253
Mailing Address - Country:US
Mailing Address - Phone:314-251-5830
Mailing Address - Fax:314-251-5803
Practice Address - Street 1:625 S NEW BALLAS RD
Practice Address - Street 2:STE 2030
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-8253
Practice Address - Country:US
Practice Address - Phone:314-251-5830
Practice Address - Fax:314-251-5803
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MERCY AFFILIATED PHYSICIANS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-05-23
Last Update Date:2008-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty