Healthcare Provider Details

I. General information

NPI: 1710124698
Provider Name (Legal Business Name): MERCY HEALTH SYSTEM CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/14/2009
Last Update Date: 06/16/2025
Certification Date: 06/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

N2950 STATE ROAD 67 RM G218
LAKE GENEVA WI
53147-2655
US

IV. Provider business mailing address

1000 MINERAL POINT AVE
JANESVILLE WI
53548-2940
US

V. Phone/Fax

Practice location:
  • Phone: 262-245-0535
  • Fax:
Mailing address:
  • Phone: 608-756-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number310800
License Number StateWI

VIII. Authorized Official

Name: JOSEPH D MALAS
Title or Position: CFO
Credential:
Phone: 815-971-6738