Healthcare Provider Details
I. General information
NPI: 1851326920
Provider Name (Legal Business Name): MERCY MEDICAL CENTER-DUBUQUE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/11/2006
Last Update Date: 10/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
250 MERCY DR
DUBUQUE IA
52001-7320
US
IV. Provider business mailing address
250 MERCY DR
DUBUQUE IA
52001-7320
US
V. Phone/Fax
- Phone: 563-589-8000
- Fax: 563-589-9029
- Phone: 563-589-8000
- Fax: 563-589-9029
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 273R00000X |
| Taxonomy | Psychiatric Hospital Unit |
| License Number | 310003H |
| License Number State | IA |
VIII. Authorized Official
Name: MS.
KAY
L
TAKES
Title or Position: PRESIDENT
Credential:
Phone: 563-589-8061