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General NPI Number Information
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NPI Number | 1376676189
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Entity Type | Organization
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Legal Business Name | MERCY HEALTH SYSTEM CORPORATION
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Dates
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Enumeration Date | 03/13/2007
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Last Update Date | 01/07/2009
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Provider Practice Location Address
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Address Line | 300 UNION ST
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City | EVANSVILLE
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State | WI
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Zip | 53536-1175
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Country | US
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Telephone | 608-882-5613
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Fax |
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Provider Business Mailing Address
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Address Line | 1000 MINERAL POINT AVE
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City | JANESVILLE
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State | WI
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Zip | 53548-2940
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Country | US
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Telephone | 608-756-6000
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Fax |
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Authorized Official
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Title or Position | VP CFO
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Name | JOHN W COOK
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Credential |
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Telephone | 608-756-6000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 310-800
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License Number State | WI
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