Provider Demographics
NPI:1760589832
Name:MERCY HEALTH SERVICES/IOWA CORP.
Entity Type:Organization
Organization Name:MERCY HEALTH SERVICES/IOWA CORP.
Other - Org Name:MERCY ALGONA DIALYSIS
Other - Org Type:Doing Business As
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 1:621 S ILLINOIS AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:MASON CITY
Mailing Address - State:IA
Mailing Address - Zip Code:50401-5489
Mailing Address - Country:US
Mailing Address - Phone:641-494-3041
Mailing Address - Fax:641-494-3059
Practice Address - Street 1:215 W CALL ST
Practice Address - Street 2:
Practice Address - City:ALGONA
Practice Address - State:IA
Practice Address - Zip Code:50511-2306
Practice Address - Country:US
Practice Address - Phone:855-322-7047
Practice Address - Fax:515-295-4216
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2013-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0600643Medicaid
IA62312OtherWELLMARK
IA0600643Medicaid