Provider Demographics
NPI: | 1417481854 |
---|---|
Name: | BAUM HARMON MERCY HOSPITAL |
Entity Type: | Organization |
Organization Name: | BAUM HARMON MERCY HOSPITAL |
Other - Org Name: | MERCYONE PRIMGHAR WOUND CARE CENTER |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | BOARD PRESIDENT |
Authorized Official - Prefix: | |
Authorized Official - First Name: | ANDREW |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | SCHIERHOLZ |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 712-279-2018 |
Mailing Address - Street 1: | 335 N WELCH AVE |
Mailing Address - Street 2: | |
Mailing Address - City: | PRIMGHAR |
Mailing Address - State: | IA |
Mailing Address - Zip Code: | 51245-1059 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 712-957-5575 |
Mailing Address - Fax: | 712-957-3340 |
Practice Address - Street 1: | 335 N WELCH AVE |
Practice Address - Street 2: | |
Practice Address - City: | PRIMGHAR |
Practice Address - State: | IA |
Practice Address - Zip Code: | 51245-1059 |
Practice Address - Country: | US |
Practice Address - Phone: | 712-957-5575 |
Practice Address - Fax: | 712-957-3340 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2017-04-12 |
Last Update Date: | 2020-02-24 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 163WW0000X | Nursing Service Providers | Registered Nurse | Wound Care | Group - Multi-Specialty |