Provider Demographics
NPI:1326331695
Name:BAUM HARMON MERCY HOSPITAL
Entity Type:Organization
Organization Name:BAUM HARMON MERCY HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF FINANCE712957
Authorized Official - Prefix:MS
Authorized Official - First Name:SUE
Authorized Official - Middle Name:E
Authorized Official - Last Name:MCCAULEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-957-2300
Mailing Address - Street 1:PO BOX 528
Mailing Address - Street 2:
Mailing Address - City:PRIMGHAR
Mailing Address - State:IA
Mailing Address - Zip Code:51245-0528
Mailing Address - Country:US
Mailing Address - Phone:712-957-2300
Mailing Address - Fax:712-957-0300
Practice Address - Street 1:255 N WELCH AVE
Practice Address - Street 2:
Practice Address - City:PRIMGHAR
Practice Address - State:IA
Practice Address - Zip Code:51245-7765
Practice Address - Country:US
Practice Address - Phone:712-957-2300
Practice Address - Fax:712-957-0300
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MERCY HEALTH SERVICES-IOWA CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-05-19
Last Update Date:2011-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty