Healthcare Provider Details

I. General information

NPI: 1477065332
Provider Name (Legal Business Name): MERCY SERVICES IOWA CITY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2017
Last Update Date: 05/11/2023
Certification Date: 05/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 CREES ST
WEST LIBERTY IA
52776-1029
US

IV. Provider business mailing address

500 E MARKET ST
IOWA CITY IA
52245-2633
US

V. Phone/Fax

Practice location:
  • Phone: 319-627-2132
  • Fax: 319-627-2087
Mailing address:
  • Phone: 319-339-3540
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MICHELE ANN BOGS
Title or Position: EXECUTIVE ASSISTANT
Credential:
Phone: 319-339-3540