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NPI Code Detail

MEDICARE: MERCY FAMILY PHARMACY

MEDICARE: MERCY FAMILY PHARMACY
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
1333600000XPharmacy
23336C0003XCommunity/Retail Pharmacy1047IA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12029731OTHERPK
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1528155710
Entity Type Code : Organization
Provider Name (Legal Business Name) : MERCY FAMILY PHARMACY
Provider Business Mailing Address
First Line : 805 JOHNSON ST SW
Second Line :
City : CASCADE
State : IA
Zip : 52033
Country : US
Telephone Number : 563-852-7757
Fax Number : 563-852-7758
Provider Business Practice Location Address
First Line : 805 JOHNSON ST SW
Second Line :
City : CASCADE
State : IA
Zip : 52033-8636
Country : US
Telephone Number : 563-852-7757
Fax Number : 563-852-7758
Authorized Official
Title or Position : PRESIDENT
Name : KAY TAKES
Credential :
Telephone Number : 563-589-8061
Provider Enumeration Date : 10/07/2006
Last Update Date : 11/22/2019

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1003903212 — MERCY FAMILY PHARMACY
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1982940920 — ANGELA VERVOORT PA-C
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805 JOHNSON ST SW
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1245855758 — JENIFER RUTH DEUTMEYER MCGOVERN PHARMD
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1831127935 — STEVEN P BRADLEY DDS
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714 1ST AVE E
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Directions to “MERCY FAMILY PHARMACY ” Practice Location

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