Healthcare Provider Details

I. General information

NPI: 1780613372
Provider Name (Legal Business Name): MERCY MEDICAL CENTER-DUBUQUE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 10/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 3RD ST SW
DYERSVILLE IA
52040-1725
US

IV. Provider business mailing address

250 MERCY DR
DUBUQUE IA
52001-7320
US

V. Phone/Fax

Practice location:
  • Phone: 563-589-8000
  • Fax: 563-589-9029
Mailing address:
  • Phone: 563-589-8000
  • Fax: 563-589-9029

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number310003H
License Number StateIA

VIII. Authorized Official

Name: MS. KAY L TAKES
Title or Position: PRESIDENT
Credential:
Phone: 563-589-8061