Organization · Type 2 NPI

Mercy Medical Group

Non-Pharmacy Dispensing Site · Cameron Park, CA

NPI number 1073829636 Active

Practice location

3427 Robin Ln, 100
Cameron Park, CA 95682-7254

Call (530) 676-7337 Map

Mailing address

5626 Oberlin Dr, Suite 110
San Diego, CA 92121-1705

Specialties and licenses

Taxonomy	Code	License
Non-Pharmacy Dispensing Site Primary	332900000X	G64540 (CA)

Non-Pharmacy Dispensing Site: A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.)

5 other providers at this address

Other non-pharmacy dispensing site providers in Cameron Park

Cancer and Blood Specialty ClinicNon-Pharmacy Dispensing Site Cameron Park, CA NPI 1154282127

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NPI record

NPI: 1073829636
Entity type: Organization (Type 2)
Issued: Aug 20, 2010
Last updated: Oct 23, 2012
Status: Active
Subpart: Yes of Medvantx, Inc.

Other names

<unavail>
Mercy Medical Group - Cameron Park, A Service of CHW · doing business as

Authorized official

Kenny Heine
Sr. Director Operations
(858) 625-2990

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1073829636

Mercy Medical Group's National Provider Identifier is 1073829636, issued on Aug 20, 2010. The primary taxonomy on file is Non-Pharmacy Dispensing Site (332900000X), and the practice location is in Cameron Park, CA. The record was last updated on Oct 23, 2012.