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General NPI Number Information
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NPI Number | 1083649206
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Entity Type | Organization
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Legal Business Name | MERCY MEDICAL CENTER-DUBUQUE
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Dates
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Enumeration Date | 07/12/2006
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Last Update Date | 02/19/2020
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Provider Practice Location Address
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Address Line | 250 MERCY DR
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City | DUBUQUE
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State | IA
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Zip | 52001-7320
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Country | US
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Telephone | 563-589-8000
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Fax | 563-589-9029
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Provider Business Mailing Address
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Address Line | 250 MERCY DR
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City | DUBUQUE
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State | IA
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Zip | 52001-7320
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Country | US
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Telephone | 563-589-8000
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Fax | 563-589-9029
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. KAY L TAKES
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Credential |
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Telephone | 563-589-8061
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 310003H
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License Number State | IA
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