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NPI Code Detail

MEDICARE: MERCY HEALTH SYSTEM CORPORATION

MEDICARE: MERCY HEALTH SYSTEM CORPORATION
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1332B00000XDurable Medical Equipment & Medical Supplies310-800WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
152D02033323OTHERWICLIA

General Provider Information

NPI Number : 1487924593
Entity Type Code : Organization
Provider Name (Legal Business Name) : MERCY HEALTH SYSTEM CORPORATION
Provider Business Mailing Address
First Line : 1000 MINERAL POINT AVE
Second Line :
City : JANESVILLE
State : WI
Zip : 53548-2940
Country : US
Telephone Number : 608-756-6000
Fax Number :
Provider Business Practice Location Address
First Line : 3400 DEERFIELD DRIVE
Second Line :
City : JANESVILLE
State : WI
Zip : 53546-3557
Country : US
Telephone Number : 608-314-3660
Fax Number : 608-314-3661
Authorized Official
Title or Position : VP/CFO
Name : JOHN W COOK
Credential :
Telephone Number : 608-756-6000
Provider Enumeration Date : 01/05/2012
Last Update Date : 01/05/2012

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Directions to “MERCY HEALTH SYSTEM CORPORATION ” Practice Location

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