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General NPI Number Information
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NPI Number | 1760426431
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Entity Type | Organization
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Legal Business Name | BAUM HARMON MERCY HOSPITAL
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Dates
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Enumeration Date | 06/15/2006
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Last Update Date | 12/30/2016
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Provider Practice Location Address
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Address Line | 255 NORTH WELCH AVE
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City | PRIMGHAR
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State | IA
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Zip | 51245
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Country | US
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Telephone | 712-957-2300
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Fax | 712-957-0300
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Provider Business Mailing Address
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Address Line | 621 S ILLINOIS AVE SUITE 103
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City | MASON CITY
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State | IA
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Zip | 50401-5489
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Country | US
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Telephone | 641-428-3041
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Fax | 641-428-3059
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Authorized Official
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Title or Position | COO/CEO
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Name | ANGIE SHILLING
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Credential |
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Telephone | 712-957-2300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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