Provider Demographics
NPI:1679742852
Name:MERCY HEALTH SERVICES/IOWA CORP
Entity Type:Organization
Organization Name:MERCY HEALTH SERVICES/IOWA CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:RODNEY
Authorized Official - Middle Name:G
Authorized Official - Last Name:SCHLADER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:641-422-7349
Mailing Address - Street 1:1000 4TH ST SW
Mailing Address - Street 2:JOHNSTON CENTER
Mailing Address - City:MASON CITY
Mailing Address - State:IA
Mailing Address - Zip Code:50401-2800
Mailing Address - Country:US
Mailing Address - Phone:641-422-6391
Mailing Address - Fax:
Practice Address - Street 1:1000 4TH ST SW
Practice Address - Street 2:JOHNSTON CENTER
Practice Address - City:MASON CITY
Practice Address - State:IA
Practice Address - Zip Code:50401-2800
Practice Address - Country:US
Practice Address - Phone:641-422-6391
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-21
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IACCDP00012Medicare PIN