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General NPI Number Information
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NPI Number | 1598718603
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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 | 05/18/2006
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Last Update Date | 06/11/2025
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Provider Practice Location Address
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Address Line | 580 N WASHINGTON ST
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City | JANESVILLE
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State | WI
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Zip | 53548-2984
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Country | US
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Telephone | 608-741-7630
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Fax | 608-741-6890
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Provider Business Mailing Address
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Address Line | PO BOX 5081
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City | JANESVILLE
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State | WI
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Zip | 53547-5081
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Country | US
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Telephone | 608-741-7630
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Fax | 608-741-6890
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Authorized Official
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Title or Position | CFO - AUTHORIZED OFFICIAL
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Name | JOSEPH D MALAS
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Credential |
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Telephone | 815-971-6738
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 310800
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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