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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
1332BC3200XCustomized Equipment (DME)310-800WI
2332B00000XDurable Medical Equipment & Medical Supplies310-800WI

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10903300038OTHERWIDME MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2118281OTHERMAMMO
352D0392857OTHERCLIA

General Provider Information

NPI Number : 1588795116
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 : 3524 E MILWAUKEE ST
Second Line :
City : JANESVILLE
State : WI
Zip : 53546-1626
Country : US
Telephone Number : 608-756-7100
Fax Number : 608-756-4700
Authorized Official
Title or Position : CFO
Name : SHANNON DUNPHY-ALEXANDER
Credential :
Telephone Number : 608-757-3126
Provider Enumeration Date : 03/07/2007
Last Update Date : 03/18/2026

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Directions to “MERCY HEALTH SYSTEM CORPORATION ” Practice Location

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