MEDICARE: MERCY HEALTH SERVICES/IOWA CORP.

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
1	333600000X	Pharmacy	951	IA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1617224	OTHER	IA	NABP
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1497837991
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MERCY HEALTH SERVICES/IOWA CORP.

Provider Business Mailing Address
First Line	:	621 S ILLINOIS AVE
Second Line	:	SUITE 103
City	:	MASON CITY
State	:	IA
Zip	:	50401-5489
Country	:	US
Telephone Number	:	641-494-3041
Fax Number	:	641-494-3059

Provider Business Practice Location Address
First Line	:	101 WEST MAIN
Second Line	:
City	:	LIME SPRINGS
State	:	IA
Zip	:	52155-0000
Country	:	US
Telephone Number	:	800-593-5463
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	RODNEY G SCHLADER
Credential	:
Telephone Number	:	641-422-7349

Provider Enumeration Date	:	10/20/2006
Last Update Date	:	08/22/2020

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