Provider Demographics
NPI:1598222341
Name:MERCYCARE HMO, INC
Entity Type:Organization
Organization Name:MERCYCARE HMO, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR VP
Authorized Official - Prefix:
Authorized Official - First Name:E
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:CRANLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-895-2421
Mailing Address - Street 1:580 N WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:JANESVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53548-2984
Mailing Address - Country:US
Mailing Address - Phone:608-741-3345
Mailing Address - Fax:
Practice Address - Street 1:580 N WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:JANESVILLE
Practice Address - State:WI
Practice Address - Zip Code:53548-2984
Practice Address - Country:US
Practice Address - Phone:608-741-3345
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MERCY HEALTH SYSTEM CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-02-28
Last Update Date:2019-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization