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NPI Code Detail

MEDICARE: MERCY HEALTH SYSTEM CORPORATION

MEDICARE: MERCY HEALTH SYSTEM CORPORATION
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
13336C0003XCommunity/Retail Pharmacy
2333600000XPharmacy7648WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
15101302OTHEROTHER ID NUMBER-COMMERCIAL NUMBER
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1467498857
Entity Type Code : Organization
Provider Name (Legal Business Name) : MERCY HEALTH SYSTEM CORPORATION
Provider Business Mailing Address
First Line : 1010 N WASHINGTON ST
Second Line :
City : JANESVILLE
State : WI
Zip : 53548-1500
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3524 E MILWAUKEE ST
Second Line :
City : JANESVILLE
State : WI
Zip : 53546-1626
Country : US
Telephone Number : 608-754-5194
Fax Number : 608-756-8496
Authorized Official
Title or Position : CFO
Name : SHANNON DUNPHY-ALEXANDER
Credential :
Telephone Number : 608-757-3126
Provider Enumeration Date : 06/22/2006
Last Update Date : 05/19/2026

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Directions to “MERCY HEALTH SYSTEM CORPORATION ” Practice Location

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