Provider Demographics
NPI:1710903364
Name:MERCY CLINICS, INC
Entity Type:Organization
Organization Name:MERCY CLINICS, INC
Other - Org Name:MERCYONE BEAVERDALE FAMILY MEDICINE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-358-6960
Mailing Address - Street 1:PO BOX 1475
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50305-1475
Mailing Address - Country:US
Mailing Address - Phone:515-271-6333
Mailing Address - Fax:515-271-6175
Practice Address - Street 1:1750 48TH ST
Practice Address - Street 2:SUITE 1
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50310-1988
Practice Address - Country:US
Practice Address - Phone:515-271-6333
Practice Address - Fax:515-271-6175
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-15
Last Update Date:2019-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0114983Medicaid
IACD3776OtherRAILROAD MEDICARE
IACD3776OtherRAILROAD MEDICARE