Organization
MERCY HEALTH SYSTEM CORPORATION
Active
Parent organization
MERCY ALLIANCE INC
Other names
MERCY HEALTH MALL
Organization subpart
Yes
Provider details
NPI number
Legal business name
MERCY ALLIANCE INC
Authorized official
JOHN W COOK (VP CFO)
(608) 756-6000
Entity
Organization
Contact information
Practice address
1010 N WASHINGTON ST, JANESVILLE, WI 53548-1561
(608) 741-2430
Mailing address
1000 MINERAL POINT AVE, JANESVILLE, WI 53548-2940
(608) 756-6000
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
310800
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1033235874
WI MEDICAID DME
WI
01
—
52D0955744
CLIA
—
Enumeration date
03/22/2007
Last updated
06/03/2010
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