MEDICARE: MERCY CLINICS INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	CD3776	OTHER	IA	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225051329
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MERCY CLINICS INC

Provider Business Mailing Address
First Line	:	PO BOX 1475
Second Line	:
City	:	DES MOINES
State	:	IA
Zip	:	50305-1475
Country	:	US
Telephone Number	:	515-222-7700
Fax Number	:	515-222-7138

Provider Business Practice Location Address
First Line	:	1601 NW 114TH ST
Second Line	:	SUITE 240
City	:	CLIVE
State	:	IA
Zip	:	50325-7036
Country	:	US
Telephone Number	:	515-222-7700
Fax Number	:	515-222-7138

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	DAVID H VELLINGA
Credential	:
Telephone Number	:	515-247-4278

Provider Enumeration Date	:	07/26/2006
Last Update Date	:	06/15/2011

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Directions to “MERCY CLINICS INC ” Practice Location

Language	Start Address	Practice Location

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