Provider Demographics
NPI:1548209984
Name:BAUM HARMON MERCY HOSPITAL
Entity Type:Organization
Organization Name:BAUM HARMON MERCY HOSPITAL
Other - Org Name:MERCYONE SUTHERLAND FAMILY MEDICINE
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:712-363-1075
Mailing Address - Street 1:PO BOX 500
Mailing Address - Street 2:
Mailing Address - City:SUTHERLAND
Mailing Address - State:IA
Mailing Address - Zip Code:51058-7672
Mailing Address - Country:US
Mailing Address - Phone:712-446-2567
Mailing Address - Fax:712-446-2612
Practice Address - Street 1:108 W 2ND ST
Practice Address - Street 2:
Practice Address - City:SUTHERLAND
Practice Address - State:IA
Practice Address - Zip Code:51058-7672
Practice Address - Country:US
Practice Address - Phone:712-446-2567
Practice Address - Fax:712-446-2612
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-04
Last Update Date:2020-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0634972Medicaid
IA0634972Medicaid
IA17142Medicare PIN