Healthcare Provider Details
I. General information
NPI: 1902840671
Provider Name (Legal Business Name): MERCY MEDICAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/15/2006
Last Update Date: 02/19/2020
Certification Date: 02/19/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
321 MILL ST
AKRON IA
51001-7712
US
IV. Provider business mailing address
PO BOX 328
SIOUX CITY IA
51102-0328
US
V. Phone/Fax
- Phone: 712-568-2411
- Fax: 712-568-2849
- Phone: 712-279-5830
- Fax: 712-279-5883
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363AM0700X |
| Taxonomy | Medical Physician Assistant |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QR1300X |
| Taxonomy | Rural Health Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
M ELIZABETH
FLANNERY-HUGHES
Title or Position: PRESIDENT
Credential:
Phone: 712-279-2018