Provider Demographics
NPI:1457863318
Name:MERCY SERVICES IOWA CITY, INC.
Entity Type:Organization
Organization Name:MERCY SERVICES IOWA CITY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROJECTS & MEMBER SERVICES COORD
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:L
Authorized Official - Last Name:FORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-339-3993
Mailing Address - Street 1:1486 S 1ST AVE STE B
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52240-6072
Mailing Address - Country:US
Mailing Address - Phone:319-339-3992
Mailing Address - Fax:319-358-2628
Practice Address - Street 1:402 S WALNUT ST
Practice Address - Street 2:
Practice Address - City:NORTH ENGLISH
Practice Address - State:IA
Practice Address - Zip Code:52316-9559
Practice Address - Country:US
Practice Address - Phone:319-664-3211
Practice Address - Fax:319-664-3212
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-01
Last Update Date:2020-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care