Provider Demographics
NPI:1124125216
Name:MERCY HEALTH SERVICES/IOWA CORP.
Entity type:Organization
Organization Name:MERCY HEALTH SERVICES/IOWA CORP.
Other - Org Name:<UNAVAIL>
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 1:621 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 1:707 GILBERT ST
Practice Address - Street 2:
Practice Address - City:CHARLES CITY
Practice Address - State:IA
Practice Address - Zip Code:50616-2703
Practice Address - Country:US
Practice Address - Phone:641-228-3567
Practice Address - Fax:641-228-3577
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2011-10-26
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
IA163506Medicare Oscar/Certification