Organization
MERCY MEDICAL CENTER
Active
Organization
MERCY MEDICAL CENTER
Active
Other names
Hall Perrine Cancer Center Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY L CHARLES (PRESIDENT AND CEO)
(319) 398-6697
Entity
Organization
Contact information
Practice address
701 10TH ST SE, CEDAR RAPIDS, IA 52403-1251
(319) 398-6343
(319) 862-1398
Mailing address
701 10TH ST SE, CEDAR RAPIDS, IA 52403-1251
(319) 398-6343
(319) 862-1398
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
1406
IA
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1114923513
—
IA
01
—
2127514
PK
—
Enumeration date
06/22/2005
Last updated
08/23/2021
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