Healthcare Provider Details

I. General information

NPI: 1376702217
Provider Name (Legal Business Name): MERCY MEDICAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2008
Last Update Date: 10/18/2024
Certification Date: 10/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 DAKOTA DUNES BLVD SUITE 200
DAKOTA DUNES SD
57049-5461
US

IV. Provider business mailing address

330 DAKOTA DUNES BLVD SUITE 200
DAKOTA DUNES SD
57049-5461
US

V. Phone/Fax

Practice location:
  • Phone: 605-232-6200
  • Fax: 605-232-0004
Mailing address:
  • Phone: 605-232-6200
  • Fax: 605-232-0004

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number
License Number State

VIII. Authorized Official

Name: JESICA HANSON
Title or Position: VP FINANCE
Credential:
Phone: 712-279-5850