Healthcare Provider Details

I. General information

NPI: 1558529206
Provider Name (Legal Business Name): MERCY MEDICAL CENTER-CENTERVILLE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2008
Last Update Date: 01/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19876 ST. JOSEPH'S DRIVE
CENTERVILLE IA
52544
US

IV. Provider business mailing address

19876 SAINT JOSEPH DR
CENTERVILLE IA
52544-8850
US

V. Phone/Fax

Practice location:
  • Phone: 641-437-3399
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: PAM YOUNG
Title or Position: BUSINESS OFFICE MANAGER
Credential:
Phone: 641-437-3413