Provider Demographics
NPI:1558719690
Name:MERCY MEDICAL SERVICES
Entity Type:Organization
Organization Name:MERCY MEDICAL SERVICES
Other - Org Name:MERCYONE STORM LAKE FAMILY MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:M ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:FLANNERY-HUGHES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-279-2018
Mailing Address - Street 1:PO BOX 1894
Mailing Address - Street 2:
Mailing Address - City:MASON CITY
Mailing Address - State:IA
Mailing Address - Zip Code:50402-1894
Mailing Address - Country:US
Mailing Address - Phone:866-494-3001
Mailing Address - Fax:641-428-3955
Practice Address - Street 1:1427 W MILWAUKEE AVE
Practice Address - Street 2:
Practice Address - City:STORM LAKE
Practice Address - State:IA
Practice Address - Zip Code:50588-2905
Practice Address - Country:US
Practice Address - Phone:712-732-9600
Practice Address - Fax:712-732-9601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-31
Last Update Date:2020-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center