Provider Demographics
NPI:1467511899
Name:MERCY TERRACE HILL SURGERY CENTER, LLC
Entity Type:Organization
Organization Name:MERCY TERRACE HILL SURGERY CENTER, LLC
Other - Org Name:MERCY RIVER HILLS SURGERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:WARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-247-8400
Mailing Address - Street 1:PO BOX 4926
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50305
Mailing Address - Country:US
Mailing Address - Phone:515-323-6400
Mailing Address - Fax:515-247-9549
Practice Address - Street 1:450 LAUREL ST.
Practice Address - Street 2:SUITE D
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50314
Practice Address - Country:US
Practice Address - Phone:515-323-6400
Practice Address - Fax:515-247-9549
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-08
Last Update Date:2020-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0610147Medicaid
IA61014OtherWELLMARK OF IOWA
IA0610147Medicaid