Healthcare Provider Details

I. General information

NPI: 1417481854
Provider Name (Legal Business Name): BAUM HARMON MERCY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2017
Last Update Date: 02/24/2020
Certification Date: 02/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

335 N WELCH AVE
PRIMGHAR IA
51245-1059
US

IV. Provider business mailing address

335 N WELCH AVE
PRIMGHAR IA
51245-1059
US

V. Phone/Fax

Practice location:
  • Phone: 712-957-5575
  • Fax: 712-957-3340
Mailing address:
  • Phone: 712-957-5575
  • Fax: 712-957-3340

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WW0000X
TaxonomyWound Care Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: ANDREW SCHIERHOLZ
Title or Position: BOARD PRESIDENT
Credential:
Phone: 712-279-2018