Provider Demographics
NPI:1164475224
Name:MERCY HEALTH SERVICES- IOWA CORP
Entity Type:Organization
Organization Name:MERCY HEALTH SERVICES- IOWA CORP
Other - Org Name:MERCYONE MASON CITY HOME MEDICAL SHOP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CONNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MORRISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:641-428-6182
Mailing Address - Street 1:PO BOX 1447
Mailing Address - Street 2:
Mailing Address - City:MASON CITY
Mailing Address - State:IA
Mailing Address - Zip Code:50402-1447
Mailing Address - Country:US
Mailing Address - Phone:641-428-6444
Mailing Address - Fax:641-428-6458
Practice Address - Street 1:1501 4TH ST SW
Practice Address - Street 2:
Practice Address - City:MASON CITY
Practice Address - State:IA
Practice Address - Zip Code:50401-2737
Practice Address - Country:US
Practice Address - Phone:641-428-5920
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2021-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0484238Medicaid
IA59414OtherWELLMARK BCBS
IA0484238Medicaid