- Enrollment id
- O20231106001433
- Enrollment state
- MO
- Provider type code
- 00-85
- Provider type text
- PART A PROVIDER - CRITICAL ACCESS HOSPITAL
- Npi
- 1063117158
- Multiple npi flag
- N
- Ccn
- 261311
- Associate id
- 1153777826
- Organization name
- MERCY HOSPITAL PERRY
- Incorporation date
- 2023-03-21
- Incorporation state
- MO
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- N
- Address line 1
- 434 N WEST ST
- City
- PERRYVILLE
- State
- MO
- Zip code
- 637751359
- Practice location type
- MAIN/PRIMARY HOSPITAL LOCATION
- Subgroup - general
- N
- Subgroup - acute care
- N
- Subgroup - alcohol drug
- N
- Subgroup - childrens
- N
- Subgroup - long-term
- N
- Subgroup - psychiatric
- N
- Subgroup - rehabilitation
- N
- Subgroup - short-term
- N
- Subgroup - swing-bed approved
- N
- Subgroup - psychiatric unit
- N
- Subgroup - rehabilitation unit
- N
- Subgroup - specialty hospital
- N
- Subgroup - other
- N
- Reh conversion flag
- N