Provider Demographics
NPI:1942420864
Name:BAUM HARMON MERCY HOSPITAL
Entity Type:Organization
Organization Name:BAUM HARMON MERCY HOSPITAL
Other - Org Name:BAUM HARMON MERCY HOSPITAL-CVA
Other - Org Type:Other Name
Authorized Official - Title/Position:BOARD PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHIERHOLZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-363-1075
Mailing Address - Street 1:255 N WELCH AVE
Mailing Address - Street 2:
Mailing Address - City:PRIMGHAR
Mailing Address - State:IA
Mailing Address - Zip Code:51245-7765
Mailing Address - Country:US
Mailing Address - Phone:712-957-2300
Mailing Address - Fax:712-957-0300
Practice Address - Street 1:255 N WELCH AVE
Practice Address - Street 2:
Practice Address - City:PRIMGHAR
Practice Address - State:IA
Practice Address - Zip Code:51245
Practice Address - Country:US
Practice Address - Phone:712-957-2300
Practice Address - Fax:712-957-0300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-26
Last Update Date:2020-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA710106H174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0257246Medicaid
IA30815OtherCVA-PRO FEES BCBS
IA30815OtherCVA-PRO FEES BCBS