Healthcare Provider Details

I. General information

NPI: 1942226550
Provider Name (Legal Business Name): MERCY CLINICS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2006
Last Update Date: 04/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 LAUREL ST STE A120
DES MOINES IA
50314-3027
US

IV. Provider business mailing address

PO BOX 1475
DES MOINES IA
50305-1475
US

V. Phone/Fax

Practice location:
  • Phone: 515-643-5700
  • Fax: 515-643-5739
Mailing address:
  • Phone: 515-643-5700
  • Fax: 515-643-5739

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: SHARON PHILLIPS
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 515-358-6960