Provider Demographics
NPI:1730571100
Name:MERCY HEALTH PARTNERS
Entity type:Organization
Organization Name:MERCY HEALTH PARTNERS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:ALLORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:231-672-4888
Mailing Address - Street 1:6401 PRAIRIE ST STE 2900
Mailing Address - Street 2:
Mailing Address - City:NORTON SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:49444-7841
Mailing Address - Country:US
Mailing Address - Phone:231-672-7890
Mailing Address - Fax:231-672-7866
Practice Address - Street 1:6401 PRAIRIE ST
Practice Address - Street 2:SUITE 2900
Practice Address - City:NORTON SHORES
Practice Address - State:MI
Practice Address - Zip Code:49444-7840
Practice Address - Country:US
Practice Address - Phone:231-672-7890
Practice Address - Fax:231-672-7866
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TRINITY HEALTH - MICHIGAN
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-02-23
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI335E00000X, 332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No335E00000XSuppliersProsthetic/Orthotic Supplier